Huniinii 


UC  SOUTHERN  REGIONAL  LIBRARY  FACILITY 


G     000  005  824     8 


MEDICI 


THE  LIBRARY 

OF 

THE  UNIVERSITY 

OF  CALIFORNIA 

LOS  ANGELES 


CONFESSIO    MEDICI 


THE  MACMILLAN  COMPANY 

NEW  YORK  •  BOSTON  •  CHICAGO 
ATLANTA  •  SAN  FRANCISCO 

MACMILLAN  &  CO.,  Limited 

LONDON    •    BOMBAY   •    CALCUTTA 
MELBOURNE 

THE  MACMILLAN  CO.  OF  CANADA,  Ltd. 

TORONTO 


CONFESSIO    MEDICI 


BY   THE    WRITER   OF 

«'THE    YOUNG   PEOPLE*' 


( a  rf^-  ^ 


"  The  physician  is  the  flower  (such  as  it  is)  of  our 
civilisation  ;  and  when  that  stage  of  man  is  done  with, 
and  only  remembered  to  be  marvelled  at  in  history, 
he  will  be  thought  to  have  shared  as  little  as  any  in 
the  defects  of  the  period,  and  most  notably  exhibited 
the  virtues  of  the  race." 

Stevenson. 


THE   MACMILLAN   COMPANY 
1908 

^11  rights  reserved 


Copyright,  1908, 
By  the  MACMILLAN  COMPANY. 


Set  up  and  electrotyped.     Published  February,  1908.     Reprinted 
June,  1908. 


Norfajoob  53w88 

J.  8.  Gushing  Co.  —  Berwick  &  Smith  Co. 

Norwood.  Mass.,  U.S.A. 


Bieraediral 
Library 

PlJf7t 


PREFACE 


A  POOR  writer  is  always  tempted  by  the  titles  of 
old  books.  It  is  hard  on  him,  that  he  may  not 
write  again  '  The  Anatomy  of  Melancholy/  or 
'  Pride  and  Prejudice/  or  '  A  Midsummer  Night's 
Dream/  But  I,  not  daring  to  steal  from  one 
of  my  betters,  have  stolen  from  two ;  from  Sir 
Thomas  Browne  and  from  Gower.  Consider  what 
temptation  is  exposed  on  the  top  of  Gower*s 
monument.  There  he  lies,  as  near  as  he  can  get 
to  Shakspeare's  brother :  and  his  effigy  has  for 
a  pillow  his  three  books,  whose  titles,  'Vox 
Clamantis,'  '  Speculum  Meditantis,'  '  Confessio 
Amantis/  make  me  say  to  myself,  as  Bliicher  said 
of  London,  fFas  fiir  Plunder.  If  only  I  might 
have  them,  which  would  be  no  loss  to  Gower,  I 
could  write  a  most  noble  trilogy.  '  Vox  Clamantis  * 
would  be  easy  work :  it  would  write  itself,  in  a 
fortnight,  in  a  red-hot  rage,  all  drums  and  trum- 
pets, thunder  and  lightning.  Then,  'Speculum 
.-Meditantis,'  in  two  big  volumes,  every  sentence 
:"5polished  and  exact :    a  book   not  to   read,   but  to 


635051 

BiMiedieal 

Libraif 


VI 


PREFACE 


give  to  public  libraries.  Last,  '  Confesslo  Amantis/ 
A  less  careful  thief  would  put  them  In  a  different 
order,  would  begin  with  '  The  Lover's  Confession,' 
young  A  murmuring  to  Miss  B,  Dearest,  I  confess 
to  you  that  I  have  been  in  love  before,  with  C,  D, 
E,  and  many,  many  other  letters  of  the  alphabet ;  but 
never  with  Ampazand.  I  swear  to  you,  my  darling, 
that  you  need  not  be  jealous  of  poor  Ampazand.  Of 
that  sort  of  Lover's  Confession,  I  only  say  that 
young  A  is  happy  and  thrice  blessed,  if  he  has 
nothing  to  confess  to  his  God  but  what  he  can 
tell  to  his  sweetheart.  But  I  have  arranged  my 
trilogy  the  right  way;  for  '  Confessio  Amantis ' 
signifies  not  the  confessions  of  a  lover,  but  con- 
fession of  love. 

Not  all  confession  is  of  sins :  and  a  man  may 
confess  his  faith,  his  ignorance,  or  his  love.  Use 
the  word  as  we  will,  it  means  no  more  than  this, 
that  he  goes  outside  himself  for  answer,  assurance, 
audience.  Faith  joins  the  company  of  the  faithful, 
ignorance  asks  for  enlightenment,  and  love  asks 
for  love.  We  do  not  talk  of  confessing  Euclid, 
or  cookery,  or  sport :  for  they  are  complete  In 
themselves.  To  confess.  Is  to  appeal  to  our  fellow- 
creatures,  it  may  be  to  one.  It  may  be  to  all,  for 
sympathy  and  a  fair  hearing. 

But  is  it  necessary,  or  wise,  or  quite  like  a 
gentleman,  thus  to  run  to  confession,  and,  as  it 
were,  to  seed?     Has  everybody  got  something  to 


PREFACE  vu 

say  worth  saying  ?  Are  not  they  the  nicest  people, 
who  say  nothing?  Indeed,  that  may  be  true;  and 
if  ever,  Hke  Prospero,  I  recover  my  dukedom,  I 
will  drown  my  book :  but  there  comes  a  time, 
even  to  people  who  might  otherwise  be  nice,  when 
they  find  pleasure  in  writing.  They  are  tired  of 
their  own  company ;  they  have  lived  inside  their 
hearts  till  they  know  every  stick  of  the  furniture: 
they  desire  now,  before  it  is  too  late,  to  leave  that 
narrow  lodging,  to  say  what  they  think,  and  to 
proclaim  what  they  have  learned.  Silence  is  golden  ; 
but  gold  is  for  circulation.  They  are  sick  of  silence  : 
it  is  not  vanity,  but  human  nature,  that  makes  them 
want  to  address  themselves  to  anybody  who  will 
Hsten  to  them.  In  brief,  they  feel  the  need  of 
confession. 

Rome  gives  this  meaning  to  the  word.  At  Rome, 
the  Confessio,  in  this  or  that  church,  is  the  wide 
sunken  space,  in  front  of  the  altar,  surrounded  by 
a  balustrade.  The  saint,  whose  body  lies  under 
the  altar,  is  by  this  device  kept  above  ground,  and 
there  is  no  right  of  way  over  his  bones.  After 
his  death,  he  found  that  he  had  not  finished  what 
he  was  saying  when  he  died.  For  that  reason,  he 
stays  among  the  living.  Between  them  and  him, 
nothing  interferes,  neither  Mother  Church  nor 
Mother  Earth :  he  is  still  in  the  world,  level  with 
present  affairs,  unburied,  attentive.  Confiteor^  says 
he ;  and  waits  for  the  word  to  come  back  to  him. 


viii  PREFACE 

That  is  why  this  part  of  the  church  is  called 
Confessio.  Here  is  no  place  for  the  confession  of 
sins :  all  such  business  must  be  transacted  else- 
where, not  with  a  saint  but  with  a  fellow-sinner,  :n 
a  box ;  not  here,  across  this  open  treasury,  walled 
with  marbles,  and  Ht  with  silver  lamps.  This 
atrium,  this  court-yard  in  front  of  the  saint's  little 
house  under  the  altar,  was  designed  for  more 
cheerful  exercises :  here,  he  gives  audience,  and 
has  requested  the  pleasure  of  my  company.  I  am 
to  stand  at  the  balustrade,  and  he  will  speak  to 
me,  confessing  his  faith,  in  the  hope  that  I  shall 
repeat  it  after  him :  but  he  has  not  the  faintest 
wish  to  hear  about  my  sins. 

People  are  so  careless,  what  they  say  to  him. 
Shock-headed  children  tell  him  how  naughty  they 
have  been,  and  pray  him  to  save  them  from  a 
whipping.  Old  women,  short  of  breath,  set  down 
their  market-baskets,  and  confide  to  him  the  gossip 
of  the  neighbourhood  and  the  state  of  their  health. 
Tourists,  which  is  the  most  unkindest  cut  of  all, 
read  guide-books  to  him,  and  he  hears,  a  dozen 
times  a  day,  who  he  is,  when  he  died,  and  how 
many  lamps  are  burning  in  front  of  him.  But  of 
course,  say  the  tourists,  you  mustnt  believe  all  that ; 
and  I  dont  suppose  for  a  moment  that  he  is  really 
there:  which  is  our  way,  when  we  visit  the  Eternal 
City.  The  porter  cheated  us  on  Monday,  and  the 
flower-girl   was   so   impudent    on    Tuesday,   and  it 


PREFACE  ix 

rained  all  Wednesday,  and  to-day  is  only  Thursday, 
and  is  it  likely,  that  a  saint  would  be  genuine  ? 
Thus  we  see  Rome,  and  make  ourselves  beloved 
there.  Anyhow,  here  I  stand  at  the  approach  to 
his  house,  and  might  be  in  a  worse  place :  for  he 
is  a  most  eloquent  handful  of  dust,  and  of  great 
age.  He  loves  courtesy,  he  hates  controversy :  he 
knows  nothing,  happy  saint,  of  the  way  I  pro- 
nounce Latin.  He  asks  me,  not  to  confess  my 
sins  to  him,  but  to  say  his  Confiteor  with  him. 
What  can  I  do,  as  one  gentleman  to  another,  but 
hide  the  guide-book,  and  endeavour  to  say  some- 
thing suitable  to  the  occasion  ? 

It  is  in  this  sense,  and  no  other,  that  the  word 
Confessio  is  used  here.  For  here  is  no  confession 
of  sins  and  errors,  no  disclosure  of  secrets,  no 
mention  of  names,  no  memory  of  offence,  no  airs 
of  penitence.  I  neither  ravel-out  my  weaved-up 
follies,  nor  complain  that  I  wasted  Time,  and  now 
doth  Time  waste  me.  Even  if  it  were  true,  I  am 
not  minded  to  talk  in  that  silly  way.  I  only  want 
to  confess  what  I  have  learned,  so  far  as  I  have 
come,  from  my  life,  so  far  as  it  has  gone. 


Biomediai 
Libraiy 

W 

PUf7e. 

CONTENTS 

FAGB 

Preface     

V 

V  OCATION     ....•< 

Hospital  Life 

II 

An  Essay  for  Students     . 

26 

A  Good  Example       .... 

55 

Practice 

.       69 

The  Discipline  of  Practice 

«       83 

The  Spirit  of  Practice    . 

•       95 

Wreaths  and  Crosses  of  Practice 

.     114 

Retirement        .... 

.     126 

The  Very  End 

•     145 

Epilogue 

.     156 

VOCATION 

It  is  said  that  there  is  a  difference  between  pro- 
fession and  vocation ;  that  the  doctor  has  a 
profession,  and  the  priest  has  a  vocation.  But  I 
find,  from  Johnson's  Dictionary,  that  Swift  uses 
the  latter  word  of  the  vilest  of  all  trades,  and  that 
Shakspeare  makes  Joan  of  Arc  use  it  of  her  con- 
temptible estate  as  a  farm-hand  : 

Lo,  whilst  I  waited  on  my  tender  lambs. 

And  to  sun's  parching  heat  displayed  my  cheeks, 

God's  Mother  deigned  to  appear  to  me  : 

And,  in  a  vision  full  of  majesty. 

Willed  me  to  leave  my  base  vocation. 

And  free  my  country  from  calamity. 

He  misses  the  point,  that  her  voices  were  her 
vocation.  That  is  the  worst  of  Latin  words  :  they 
are  good  servants,  but  bad  masters.  When  I  meet 
a  long  Latin  word,  in  a  line  of  quiet  English, 
elbowing  its  neighbours  right  and  left,  like  a 
motor-omnibus  raging  down  a  country  lane,  I  stop 
it,  and  ask  to  see    its    root.     That   is   the  way   to 


2  CONFESSIO  MEDICI 

take  the  conceit  out  of  all  such  words.  Here  is 
one,  which  so  impressed  Shakspeare  that  he  made 
four  syllables  of  it :  but  its  root,  vo  or  voc^  is  a 
mere  animal  noise,  the  cry  of  an  ape  courting 
an  ape.  Away  with  Latinity.  If  it  could  thus 
impress  Shakspeare,  what  may  it  not  do  with  us? 
Let  us  be  agreed,  that  a  vocation  is  a  call,  or  a 
caUing.  But  here  is  a  new  difficulty.  For  it  is 
one  thing,  to  have  a  call,  and  another,  to  have  a 
calling ;  and  a  man  may  have  either,  or  both. 
Joan  of  Arc  had  a  call  to  leave  her  calling : 
Burns  followed  the  calling  of  an  exciseman,  and 
the  call  of  poetry.  There  is  no  call  for  anybody 
to  run  another  music-hall  in  London,  or  to  make 
a  huge  profit,  in  time  of  war,  out  of  his  country's 
army :  still,  a  man  thus  engaged  might  say  that 
he  had  a  calling.  Again,  a  man  is  called  to  the 
Bar :  but  they  are  mortal  voices  which  call  him, 
and  most  unlike  those  heard  by  Joan  of  Arc. 
Again,  in  Medicine,  many  of  us  are  glad  that  we 
have  a  calling,  but  doubtful  whether  we  had  a  call. 
It  is  certain,  that  some  men  are  indeed  called 
to  be  doctors :  and  so  are  some  women.  They 
are,  as  we  say,  born  doctors  :  they  were  shapen  in 
Medicine.  So  apt  are  they  to  their  work,  and  it 
to  them,  that  they  almost  persuade  me  to  hold 
opinion  with  Pythagoras,  and  to  believe  that  in 
some  previous  existence  they  were  in  general 
practice.     Or  their   ability    may    be  the    result    of 


VOCATION  3 

inheritance :  but  we  know  next  to  nothing  about 
inheritance,  neither  is  it  imaginable  by  what 
physical  processes  the  babe  unborn  is  predisposed 
for  one  profession.  Still,  there  are  men  and 
women,  but  not  a  great  number,  created  for  the 
service  of  Medicine :  who  were  called  to  be 
doctors  when  they  were  not  yet  called  to  be  babies. 

To  this  word  call^  Johnson  assigns  no  less  than 
nine  meanings  :  but  I  am  concerned  only  with 
those  which  he  numbers  3  and  4,  quoting  in 
support  of  them  the  honoured  names  of  Milton, 
Dryden,  and  Locke.  Call  3  is  divine  vocation, 
summons  to  true  religion  :  call  4  is  a  summons 
from  heaven,  an  impulse.  I  cannot  see  any 
difference  between  divine  vocation  and  a  summons 
from  heaven,  or  between  a  summons  from  heaven 
and  a  summons  to  true  religion.  To  say  that  a 
man  is  called  to  be  a  doctor,  is  no  more  than 
to  say  that  he  is  designed  for  that  life,  as  coals 
are  designed  for  fuel,  and  candles  for  light.  And, 
of  course,  a  call  is  not  bound  to  be  ante-natal : 
it  can  come  when  it  likes.  For  example,  take,  in 
Middlemarchy  Lydgate's  call : 

One  vacation,  a  wet  day  sent  him  to  the  small  home- 
library,  to  hunt  once  more  for  a  book  which  might  have 
some  freshness  for  him  :  in  vain  !  unless,  indeed,  he  took 
down  a  dusty  row  of  volumes  with  grey-paper  backs  and  dingy 
labels  —  the  volumes  of  an  old  Cyclopaedia  which  he  had  never 
disturbed.  .  .  .  The  page  he  opened  on  was  under  the  head  of 
Anatomy,   and  the   first  passage  that   drew  his   eyes  was   on   the 


4  CONFESSIO   MEDICI 

valves  of  the  heart.  He  was  not  much  acquainted  with  valves 
of  any  sort,  but  he  knew  that  valvae  were  folding  doors,  and 
through  this  crevice  came  a  sudden  light  startling  him  with 
his  first  vivid  notion  of  finely-adapted  mechanism  in  the 
human  frame.  .  .  .  The  moment  of  vocation  had  come,  and, 
before  he  got  down  from  his  chair,  the  world  was  made  new 
to  him  by  a  presentment  of  endless  processes  filling  the  vast  spaces 
planked  out  of  his  sight  by  that  wordy  ignorance  which  he 
had  supposed  to  be  knowledge.  From  that  hour,  Lydgate  felt 
the  growth  of  an  intellectual  passion. 

But,  if  the  call  had  been  addressed  to  his  intellect 
alone,  he  would  have  turned  toward  science  rather 
than  practice.     Therefore  we  read  again  of  him  : 

His  scientific  interest  soon  took  the  form  of  a  professional 
enthusiasm.  .  .  .  He  carried  to  his  studies  in  London,  Edin- 
burgh, and  Paris,  the  conviction  that  the  medical  profession  as 
it  might  be  was  the  finest  in  the  world ;  presenting  the  most 
perfect  interchange  between  science  and  art ;  offering  the  most 
direct  alHance  between  intellectual  conquest  and  the  social 
good.  Lydgate' s  nature  demanded  this  combination  :  he  was 
an  emotional  creature,  with  a  flesh-and-blood  sense  of  fellow- 
ship which  withstood  all  the  abstractions  of  special  study.  He 
cared  not  only  for  *  cases,'  but  for  John  and  Elizabeth, 
especially    Elizabeth. 

Again,  he  was  called  not  only  to  science  and  to 
practice,  but  to  the  advancement  of  his  profession  : 

He  went  to  study  in  Paris  with  the  determination  that  when 
he  came  home  again  he  would  settle  in  some  provincial  town 
as  a  general  practitioner,  and  resist  the  irrational  severance 
between  medical  and  surgical  knowledge  in  the  interest  of  his 
own  scientific  pursuits,  as  well  as  of  the  general  advance  :  he 
would     keep     away     from     the     range     of    London     intrigues. 


VOCATION  5 

jealousies,  and  social  trucklings,  and  win  celebrity,  however 
slowly,  as  Jenner  had  done,  by  the  independent  value  of  his 
work. 

Read  Middlemarch,  I  say  to  all  students.  Lydgate 
died  long  ago  :  for  it  is  near  eighty  years  since  he 
started  in  practice,  at  a  time  when  most  medical 
-practice  was  still  strutting  or  shambling  along  the  old 
paths.  But  the  whole  story  of  his  life  —  believe  me, 
Gentlemen,  it  will  help  you  more  than  all  the  novels 
of  the  last  quarter  of  a  century.  Besides,  it  will 
save  you  from  falling  in  love  with  young  ladies  like 
Rosamond.  Read  Middlemarch,  I  tell  you :  and,  if 
Lydgate's  life  does  not  touch  you,  ask  yourselves 
whether  you  have  any  call  to  be  doctors. 

But  Lydgates  are  rare  :  and  fathers  and  mothers, 
bent  on  making  a  doctor  of  one  of  the  children, 
must  not  take  the  boy's  mere  vagaries  as  a  sign  that 
he  is  intended  for  that  profession.  /  mean  to  be  a 
doctor  like  Father^  says  he,  and  they  rejoice  over 
him  ;  and  a  month  later  he  wants  to  be  a  fireman, 
or  a  member  of  Parliament.  Or  he  is  neat  with  his 
fingers,  rides  well,  understands  the  ways  of  animals, 
and  loves  to  attend  the  minor  ailments  of  the  family  : 
and  then  all  that  side  of  him  goes,  and  he  gives 
himself  to  poetry,  or,  which  is  worse,  to  music. 
Or  he  is  ambitious,  and  will  make  a  great  name,  a 
great  discovery :  and  again  the  wind  catches  the 
weather-cock,  and  he  praises  a  leisurely  life  and  the 
happiness  of  insignificance.     His  parents  look  in  vain 


6  CONFESSIO  MEDICI 

for  such  assurance  as  may  justify  action.  Time  will 
shoWy  they  say,  and  wait ;  but  nothing  happens, 
nothing  decisive.  Something  must  be  done  ;  Time, 
still  silent,  is  up  :  they  determine,  amid  hopes  and 
fears  which  he  hardly  notices,  that  he  shall  study 
Medicine.  For  all  fathers  and  mothers  thus  per- 
plexed, there  is  consolation  in  Bacon's  essay,  '  Of 
Parents  and  Children  ' : 

Let  Parents  choose  betimes  the  Vocations  and  Courses  they 
mean  their  Children  should  take,  for  then  are  they  most  flexible  : 
and  let  them  not  too  much  apply  themselves  to  the  disposition 
of  their  Children,  as  thinking  they  will  take  best  to  that  which 
they  have  most  mind  to.  It  is  true,  that  if  the  Affection  or 
Aptness  of  the  Children  be  extraordinary,  then  it  is  good  not 
to  cross  it :  but  generally  the  precept  is  good.  Optimum  elige ;  suave 
et  facile  faciet  illud  Consuetude. 

And  what  better  profession  than  Medicine,  what 
more  liberal  and  loveable,  for  a  young  man  at  a 
loose  end  ?  As  Matthew  Arnold  said  of  religion, 
that  it  is  morality  touched  with  emotion,  so  practice 
is  science  touched  with  emotion  :  which  is  a  fine 
occupation  for  any  young  man  of  no  affection  or 
aptness  so  extraordinary  that  it  may  not  safely  be 
crossed.  If  we  all  had  to  sit  and  wait  for  such  a 
call  as  came  to  Lydgate,  many  of  us  would  be 
sitting  there  still,  wearying  our  kind  elders,  and 
sick  of  waiting.  Give  me  something  to  do,  cry 
the  young  men,  put  me  into  a  decent  profession^  and 
let  me  take  my  chance.     Jack  is  in  the  Navy,  and  Joe 


VOCATION  7 

is  in  the  City^  and  bless  me  also,  O  my  father,  and  find 
me  some  work,  1  dont  much  care  what.  Here,  in 
this  wholesome  impatience,  are  opportunity  and 
guidance :  so  it  comes  to  pass,  that  all  other  plans 
of  the  family  council  are  put  aside,  and  one  more 
young  man  sets  out  to  be  a  doctor. 

To  want  to  be  wanted,  to  fight  and  shove, 
single-handed,  for  a  place  in  the  world,  are  evidence 
of  strength.  To  count  on  the  help  and  influence 
of  other  men,  to  wonder  what  A  and  B  will  do 
for  us,  are  evidence  of  weakness.  Especially,  a 
young  man  must  be  careful  to  reckon  a  successful 
father  not  among  his  assets,  but  among  his  liabilities. 
For  he  who  enters  his  father's  profession  counting 
on  his  father's  name,  enters  it  at  his  peril:  and  his 
venture  is  the  more  perilous,  if  he  takes,  in  the 
same  profession,  the  same  line.  There  was  Icarus, 
son  of  Daedalus :  he  fashioned  for  himself  wings, 
to  follow  his  father  aloft ;  and  they  bore  him  off 
the  earth,  but  the  wax  of  them  was  melted  by 
the  sun,  and  he  fell  into  the  sea.  Practice  is  the 
solvent  of  all  such  wings :  for  it  is  the  man  himself, 
the  skill  of  his  hands,  the  judgment  of  his  reason 
on  the  expert  evidence  of  his  senses,  the  quick 
selection  and  watchful  use  of  the  right  set  of  facts. 
It  cannot  be  taken  over  like  a  theatre-ticket  or  a 
share  in  a  railway.  Name,  influence,  privilege,  suc- 
cession, are  what  we  make  them.  He  who  has  them 
must  use  them,  for  they  are   part  of  his  life,  and 


8  CONFESS lO   MEDICI 

are  there  to  be  used :  but  they  may  fail  him. 
Like  Icarus,  he  is  too  much  in  the  sun.  Expec- 
tation waits  upon  him,  and  the  word  goes  round 
that  he  ought  to  do  well,  with  such  advantages. 
It  is  pleasant  for  him,  to  rise  into  that  soft  air, 
and  try  his  wings  in  the  sunshine :  but  the  heat  of 
the  sun  may  be  too  fierce  for  them.  There  is 
nothing  disgraceful  in  that.  They  were  an  accurate 
copy  of  the  wings  of  Daedalus  :  and  every  young 
man  would  like  to  have  wings.  And,  after  all, 
though  Icarus  was  drowned,  yet  it  was  a  splendid 
adventure,  to  fly,  even  a  little  way  :  and  wax  was 
made  to  be  melted. 

Precept  and  example,  from  father  to  son,  are  gifts 
of  more  lasting  stuff;  but  they  are  not  imperish- 
able. The  place  of  each  life  in  the  other  is  always 
changing.  If  they  could  for  a  moment  stand  still, 
they  would  be  like  mirrors,  face  to  face,  each  reflect- 
ing the  other,  and  itself  in  the  other,  and  the 
reflection  of  itself  in  the  reflection  of  the  other,  in 
and  in,  to  an  immeasurable  depth  :  but  they  are 
incessantly  on  the  move.  Outside  forces,  uncalcu- 
lated  events,  interfere  between  them,  till  those  early 
influences,  which  were  so  strong,  fail.  And  then, 
at  the  last,  there  may  be  in  store  for  the  two  lives 
a  wonderful  phase,  when  precept  and  example  are 
permitted,  gently,  and  by  common  consent,  to  take 
a  rest.  They  have  done  their  work ;  they  belonged, 
it  appears,  to  the  Old  Dispensation,  the  time  when 


VOCATION  9 

home,  now  and  again,  had  a  feehng  about  it  as  of 
Mount  Sinai,  and  there  was  thunder  in  the  air. 
They  are  ended,  and  put  away.  The  father's  im- 
patience, the  son's  disaffection,  cease  to  be  remem- 
bered :  and  the  two  Hves,  what  is  left  of  them 
together,  touch,  and  stay  close,  without  apology  or 
excuse  or  explanation  or  self-pity,  and  are  united. 
But  this  phase  comes  late,  or  may  never  come : 
for  it  often  happens  that  just  as  the  two  lives  almost 
touch,  one  of  them  stops. 

Since  name  and  influence,  precept  and  example, 
and  all  else  that  our  elders  can  give  us,  are  thus 
fortuitous,  we  must  look  inside  the  man  himself, 
to  discover  what  is  the  good  of  a  call.  The  moment 
we  do  that,  we  light  on  the  obvious  fact,  that 
the  good  in  men  is  only  inside  them  because  it  is 
outside  them.  Thus  we  are  brought  back  to  John- 
son's definition,  number  ^a,  that  a  call  is  a  summons 
from  heaven.  By  what  physical  process  it  enters 
into  the  fabric  of  a  man's  life,  we  need  not  ask, 
or  wait  for  an  answer.  It  has  an  endless  series  of 
methods,  and  is  not  bound  to  any  one  of  them  : 
therefore,  its  presence  is  apt  to  be  overlooked,  and 
its  very  existence  denied  by  minute  philosophers. 
Every  year,  young  men  enter  the  medical  profession 
who  neither  are  born  doctors,  nor  have  any  great 
love  of  science,  nor  are  helped  by  name  or  influence. 
Without  a  welcome,  without  money,  without  pros- 
pects,   they   fight    their    way   into    practice,  and  in 


lo  CONFESSIO   MEDICI 

practice ;  they  find  it  hard  work,  ill-thanked, 
ill-paid :  there  are  times  when  they  say.  What  call 
had  I  to  be  a  doctor  ?  I  should  have  done  better  for 
myself  and  my  wife  and  the  children  in  some  other 
calling.  But  they  stick  to  it,  and  that  not  only 
from  necessity,  but  from  pride,  honour,  conviction  : 
and  Heaven,  sooner  or  later,  lets  them  know  what 
it  thinks  of  them.  The  information  comes  quite 
as  a  surprise  to  them,  being  the  first  received,  from 
any  source,  that  they  were  indeed  called  to  be 
doctors ;  and  they  hesitate  to  give  the  name  of 
divine  vocation  to  work  paid  by  the  job,  and 
shamefully  underpaid  at  that.  Calls,  they  imagine, 
should  master  men,  beating  down  on  them  :  surely, 
a  diploma,  obtained  by  hard  examination  and  hard 
cash,  and  signed  and  sealed  by  earthly  examiners, 
cannot  be  a  summons  from  heaven.  But  it  may 
be.  For,  if  a  doctor*s  life  may  not  be  a  divine 
vocation,  then  no  life  is  a  vocation,  and  nothing  is 
divine. 


HOSPITAL    LIFE 

Great  Hospitals,  with  their  Schools,  are  something 
more  than  blocks  of  buildings  where  patients  are 
doctored,  and  students  and  nurses  are  taught.  I 
do  believe  in  the  spirit  of  a  place.  To  me,  the 
genius  loci  is  really  there :  and  the  Religio  Discipuli, 
the  student's  obedience  to  the  spirit  of  Hospital 
life,  is  a  very  important  part  of  his  education. 

It  is  strange,  in  modern  London,  that  the  genius 
loci  still  survives  as  an  object  of  worship :  that 
here,  at  the  heart  of  the  Empire,  a  religion  lingers 
which  may  fairly  be  called  primitive.  It  bears  traces 
of  tribal  origin  :  each  Hospital  has  its  local  deity, 
whose  votaries  deride  the  gods  of  other  Hospitals 
as  idols,  but  offer  at  their  own  shrine  gifts  and 
sacrifices,  especially  on  the  first  of  October.  The 
ritual,  on  such  occasions,  is  frankly  pagan.  Let  us 
look  at  these  curious  customs,  and  observe  what 
gifts,  at  the  October  festival,  are  presented  and 
accepted.  For  there  are  sacrifices  which  are  not 
wanted,  gifts  which    might  as  well  be    left  outside 

II 


12  CONFESSIO   MEDICI 

the  precincts,  and  worthless  promises.  And  even 
the  meekest  priest  of  the  shrine  may  be  able  to 
assist  the  little  crowd  of  worshippers,  praising  one, 
rebuking  another,  advising  a  third,  and  always  on 
the  look-out  for  such  as  are  likely,  by  the  excellence 
of  their  gifts  and  the  importunity  of  their  devotion, 
to  become  priests  like  himself 

In  plain  words.  What  gifts  of  heart  and  mind 
ought  a  student  to  bring  to  the  service  of  his 
Hospital  ? 

He  ought  to  bring  those  gifts  which  come  of  a 
good  disposition,  a  good  home,  and  a  good  public 
school.  He  should  have  reverence,  and  a  fair 
Hking  for  work,  and  a  certain  simplicity  or  direct- 
ness of  thought ;  and  should  know  Latin,  and  a 
manageable  quantity  of  general  facts  ;  and  should 
be  resolute,  in  company,  and  even  against  company, 
to  say  the  right  thing  and  take  the  right  side.  One 
more  gift  he  should  have,  which  Time  alone  can 
give,  a  sufficient  age.  He  is  very  young  for  life 
in  London  :  and  it  is  well  for  him  if  his  father 
can  send  him  to  the  University,  there  to  learn  his 
preliminary  sciences,  and  thence  to  obtain,  in  due 
course,  his  degree.  And  here  I  touch  the  question. 
What  is  the  value,  to  a  medical  student  in  London, 
of  a  previous  existence  at  Cambridge  or  Oxford  ? 

But  I  am  not  thinking  of  examinations,  or  of 
the  study  of  those  sciences  which  our  students 
lightly  call  preliminary.    I  am  thinking  of  the  general 


HOSPITAL  LIFE  13 

belief,  that  a  medical  student,  who  has  been  at 
Cambridge  or  Oxford,  has  thereby  gained  not  only- 
knowledge,  but  other  accomplishments,  which  evade 
the  coarse  test  of  examination,  but  are  of  great 
help  to  him  in  Hospital  life,  and  afterward  in  prac- 
tice. An  old  University,  it  is  believed,  is  a  system 
of  impressions,  tones,  and  influences.  It  exercises 
on  all  faithful  undergraduates  the  magic  of  beautiful 
buildings,  immemorial  traditions,  immortal  names  ; 
it  sets  them  living  and  moving  in  a  wonderful  city 
where  philosophers,  poets,  statesmen,  scholars,  and 
critics  have  lived  and  moved ;  it  shows  them,  for 
the  asking,  the  true  ways  of  religion,  friendship, 
logic,  athletics,  courtesy,  and  self-judgment.  Hence- 
forth, they  are  of  the  world's  elect :  for  they  have 
been  where  they  have  been,  and  there  have  learned 
to  think  and  to  feel.  They  give  evidence  of  good 
style,  good  form,  good  taste ;  something  in  the 
clothes,  the  handwriting,  the  voice.  If  they  praise 
a  picture,  a  book,  or  a  piece  of  music,  we  had 
better  do  the  same ;  and,  if  they  reconcile  autho- 
rities who  seem  to  us  to  be  opposed,  we  may  be 
sure  that  they  are  right :  for  they  have  visions  which 
never  come  to  us,  and  they  wear  on  their  foreheads, 
like  a  phylactery,  the  University  arms.  This  belief 
is  doubtless  founded  on  fact,  and  assuredly  is  sup- 
ported by  fiction  ;  and  is  dear  to  the  foolish  people 
who  take  every  University  man  to  be  a  gentleman, 
and  treat  their  family  doctor  as  a  tradesman. 


14  CONFESSIO    MEDICI 

But  the  preliminary  sciences,  as  their  name  implies, 
are  on  the  very  threshold  of  the  undergraduate's 
life.  Even  in  his  first  year,  he  dissects  the  earth- 
worm. So  much  the  better  for  his  future  patients  : 
he  cannot  too  soon  begin  to  learn  his  proper 
business.  But  I  dare  to  ask  him,  What,  after  all, 
is  the  difference  between  the  University  earth-worm  and 
any  other  ?  You,  at  your  time  of  life,  what  have  you 
to  do  with  forms  of  thought  and  points  of  view  ?  Is 
there  more  than  the  one  way  for  you,  the  same  for  all 
of  us,  to  learn  how  to  use  your  eyes  and  your  hands  ? 
And  are  not  your  special  studies  opposed,  on  principle, 
to  the  old  magic  of  your  University  ?  He  may  answer, 
that  he  has  no  great  respect  for  the  last  enchant- 
ments of  the  Middle  Ages,  and  that  all  Universities 
ought  to  be  Centres  of  Modern  Thought :  which 
is  a  dreadful  phrase,  on  such  young  lips.  Thirty 
years  ago  it  was  the  preliminary  sciences  that  were 
despised,  and  the  nickname  for  the  whole  majestical 
circle  of  them  was  Stinks,  more  shame  to  Cambridge 
and  Oxford.  Thirty  years  hence,  at  the  present 
rate  —  but  I  only  say  that  not  even  undergraduates 
can  have  everything.  If  they  love  their  sciences 
as  they  ought,  they  may  fail  to  receive  the  non- 
scientific  influences  of  the  place. 

And  these  influences,  I  think,  are  of  very  little 
use,  either  in  Hospital  life  or  in  practice.  There 
was  a  time,  within  the  memory  of  men,  when  a 
student  from  Cambridge  or  Oxford  was  taken,  not 


HOSPITAL  LIFE  15 

without  reason,  to  be  vastly  superior  to  other 
students ;  was  observed,  envied,  privileged,  marked 
for  distinction.  If  the  Hospital  was  honoured  by 
a  sufficient  number  of  these  rare  young  men,  there 
would  be  an  University  set.  Now,  with  the  great 
and  happy  increase  of  the  supply  of  them,  and  with 
the  University  of  London  crowned  and  enthroned, 
and  with  the  rise  of  many  new  Universities,  the 
times  are  changed,  and  there  is  no  more  talk, 
Heaven  be  praised,  of  University  sets.  But  this 
change  is  not  all  due  to  the  increased  representation 
of  the  old  Universities  in  Hospital  life.  The  young 
men  from  Cambridge  or  Oxford  would  still  tend 
to  form  sets,  if  they  found  any  great  difference 
between  other  students  and  themselves.  They  do 
not  find  it,  and  that  for  two  reasons :  first,  because 
they  do  not  look  for  it,  and  next,  because  it  is  not 
there. 

They  do  not  look  for  it ;  they  are  content  to 
be  freshmen  again.  One  Alma  Mater  at  a  time  is 
enough  for  them  :  and,  as  it  were  by  instinct,  they 
give  to  their  Hospital  the  allegiance  which  they  gave 
to  their  University.  They  are  quick  to  see  that 
the  new  Alma  Mater  does  not  care  for  any  traditions 
but  her  own,  and  is  averse  from  all  academic  or 
aesthetic  modes.  She  prefers  physiology  to  philo- 
sophy, museums  to  the  Muses.  She  lets  them 
know,  at  once,  that  she  is  too  busy  to  be  interested 
in  their    accomplishments,    and  that  she  does    not 


i6  CONFESSIO    MEDICI 

want  to  think  about  thinking  and  feel  about  feeling. 
It  is  as  much  as  she  has  time  for,  to  read  the 
paper  of  a  weekday,  and  get  a  walk  in  the  park 
of  a  Sunday,  and  not  often  that :  and  as  for  stopping 
to  hear  about  poetry,  she  really  couldn't  dream  of 
such  a  thing,  with  so  many  cases  waiting  to  be 
dressed,  and  the  telephones  going,  though  of  course 
it  is  all  very  clever,  and  quite  wonderful,  what  they 
have  learned  by  heart,  and  how  they  can  remember 
so  much.  Dear,  wise,  old  Alma  Mater,  most 
practical,  most  loveable :  they  would  be  very  stupid 
young  men,  if  they  were  not  glad  to  enter  your 
service.  Besides,  they  enjoy  the  sense  of  masquerade. 
To  hide  his  pride  is  even  more  delightful,  to  a 
young  man,  than  to  air  his  pride :  then,  at  the 
appropriate  moment,  like  the  Duke  in  the  opera, 
he  can  fling  open  his  mantle,  and  show  on  his  breast 
the  glittering  star  of  the  Order  of  the  University. 
They  say  goodbye,  without  regret,  to  that  leisurely 
University  life,  which  was  so  exactly  the  right  thing 
and  the  real  article,  and  was  enclosed  in  such  a 
beautiful  place.  The  sudden  change  shakes  them 
out  of  themselves,  and  everything  has  something 
to  say  to  them  :  they  give  to  the  new  life  their 
undivided  loyalty,  and  do  not  look  for  a  line 
between  themselves  and  their  fellow-students. 

Nor  would  they  find  it,  if  they  looked.  He  who 
brings  to  his  Hospital  the  gifts  of  a  good  disposition, 
a  good  home,  and  a  good  public  school,  is  a  fair 


HOSPITAL   LIFE  17 

match  for  him  who  comes  from  an  University. 
The  Hospital  takes  us  for  what  we  are,  not  for 
where  we  were.  Inside  its  walls,  we  are  all  equal, 
and  there  is  no  opportunity  for  the  Cambridge  mind 
and  the  Oxford  mind.  It  is  doubtful,  whether  these 
minds  are  in  general  use  even  at  the  seats  of  learning 
assigned  to  them  :  it  is  certain,  that  they  are  not 
necessary  for  Hospital  life.  To  every  deserving 
community.  Heaven  gives  a  mind  :  and  provides, 
for  its  life,  a  proper  setting. 

The  setting  of  the  life  of  a  Hospital,  the  build- 
ings, and  such  works  of  art  as  the  Hospital  may 
possess,  are  shown  to  every  visitor.  But,  to  observe 
its  mind,  the  visitor  need  not  go  further  than  the 
Hospital  garden ;  that  quiet  place,  which  is  no 
more  like  the  outside  world  than  home  is  like  a 
music-hall.  For  the  genius  loci  loves  the  open  air ; 
and  the  Hospital  garden  is  his  sacred  grove.  And 
it  shall  be  summer-time,  with  patients  lying  under 
the  shade  of  the  plane-trees,  and  nurses  bringing  tea 
to  them,  and  students,  bare-headed,  playing  tennis, 
or  talking  over  the  day's  affairs,  or  just  doing 
nothing.  Of  itself,  it  may  be  not  much  of  a 
garden  :  but  we  admire  it  as  an  open  space,  a  great 
well  of  light  and  air,  a  shaft  of  health  sunk  into 
diseased  and  injured  London.  This  pleasant  old- 
fashioned  quadrangle,  blessed  with  sunshine  and 
silence  and  an  excellent  view  of  the  sky,  is  the 
centre  of  the  Hospital  life :  and  a  visitor,  loitering 


i8  CONFESSIO   MEDICI 

here,  will  see  that  we  are  a  brotherhood,  and  that 
the  patients  are  our  guests.  Every  Hospital  is  a 
charity :  but  there  is  a  difference  between  charity 
and  hospitality.  They  who  give  money  to  Hospitals 
are  charitable ;  we,  who  have  the  spending  of  it, 
are  hospitable :  and,  of  course,  it  is  we  who  get  the 
fun  out  of  the  money.  And  we  spend  it  well, 
entertaining  in  good  style  our  innumerable  guests. 

All  of  us,  staff  and  students,  sisters  and  nurses, 
residents,  lecturers,  and  officials,  work  together, 
keeping  open  house.  Our  students,  a  brotherhood 
within  a  brotherhood,  live  under  communal  rules, 
mostly  of  their  own  making.  In  some  Hospitals, 
there  are  Colleges,  where  students  reside,  with 
admirable  opportunities  for  reading,  and,  more's 
the  pity,  for  bridge ;  and  enjoy  the  intimate  life, 
a  time  so  pleasant  that  every  student  ought  to  have 
it  for  a  part,  at  least,  of  his  course.  There  is  the 
more  need,  now,  to  maintain  the  unity  of  Hospital 
life,  because  the  University  of  London  is  beginning 
to  relieve  some  Hospitals  of  the  heavy  honour  of 
teaching  the  preUminary  sciences.  The  advantages 
of  this  change  are  crossed  by  the  fear  lest  the  new 
student  should  feel  unattached.  Fm  not  much  wanted 
here^  he  might  say,  at  the  Hospital ;  and,  I  shall  not 
he  wanted  here^  once  Tm  through^  at  his  work  outside 
the  Hospital.  Every  student,  from  the  beginning, 
reckons  on  the  right  of  immediate  access  to  the  local 
deity.     But,  now  that  the  new  Universities  attract 


HOSPITAL   LIFE  19 

so  many  students  who  but  for  them  would  be  in 
London,  we  must  submit  to  change,  knowing  that 
we  are  in  good  hands.  I  have  a  dream  of  the  future. 
Within  the  estate  of  each  great  Hospital,  there  is 
a  great  College  of  the  University  of  London,  with 
rooms  for  all,  or  nearly  all,  its  students.  I  cannot 
see,  in  my  dream,  whether  the  Hospital  is  still  in 
London,  or  has  fled  into  the  country :  but  I  think 
that  it  has  fled,  and  has  left  on  its  old  site  a  little 
Hospital  for  accidents  and  emergencies.  Anyhow, 
where  the  great  Hospital  is,  there  is  the  College,  a 
splendid  range  of  buildings,  worthy  of  an  Univer- 
sity of  London,  with  Chapel,  Hall,  Common-rooms, 
Library,  swimming-bath,  gymnasium,  all  perfect. 
The  residential  life,  the  sense  of  attachment,  are 
part  of  the  secret  of  the  old  Universities  :  and  we, 
no  less,  desire  that  our  life  should  have  that  setting 
which  it  deserves. 

Or  will  anybody  say  that  the  genius  loci  is  all 
nonsense,  and  that  a  great  Hospital  is  only  a  big 
machine  ?  My  answer  is,  that  I  know  what  I  am 
talking  about.  Sickness,  as  Lucretius  says  of  im- 
pending death,  shows  us  things  as  they  are  :  the 
mask  is  torn  off,  the  facts  remain.  That  is  the 
spiritual  method  of  the  Hospital  :  it  makes  use  of 
sickness,  to  show  us  things  as  they  are.  This 
delicate  word,  sickness,  includes  drink,  the  con- 
tagious diseases,  infant  mortality,  starvation,  the 
sweating    system,    the    immigrant    alien,    dangerous 


20  CONFESSIO   MEDICI 

trades,  insanity,  childbirth,  heredity,  attempted 
suicide,  accidents,  assaults,  and  all  the  innumerable 
adventures,  tragical  or  comical,  which  end  in  the 
Casualty  Department.  To  a  young  man  of  good 
disposition,  tired  of  the  preliminary  sciences,  and  of 
humanity  stated  in  terms  of  anatomy  and  physiology 
to  the  satisfaction  of  the  examiners,  this  plunge  into 
the  actual  flood  of  lives  is  a  fine  experience. 
Hitherto,  he  has  learned  organisms  ;  now,  he  begins 
to  learn  lives.  He  need  not  go,  like  other  young 
men,  for  that  lesson,  to  the  slums ;  for  they  come 
to  him,  and  that  thrilling  drama.  How  the  Poor 
Live^  is  played  to  him,  daily,  by  the  entire  company, 
hero  and  heroine,  villain  and  victim,  comic  relief, 
scenic  effects,  and  a  great  crowd  of  supers  at  the 
back  of  the  stage  —  undesired  babies,  weedy  little 
boys  and  girls.  Hooligans,  consumptive  workpeople, 
unintelligible  foreigners,  voluble  ladies,  old  folk  of 
diverse  temperaments,  and  many,  too  many,  more 
comfortable  but  not  more  interesting  people.  It  all 
happens  so  naturally,  with  such  a  quick  and  sure 
touch :  the  reality  of  the  day's  work,  the  primal 
meaning  of  the  crowd,  the  clash  of  hand-to-hand 
encounter  with  diseases  and  injuries,  urge  him  to 
unexpected  uses  of  himself.  Here  are  the  very 
people  of  the  streets,  whom  he  passes  every  day, 
here  they  are  coming  to  him  for  help,  to  him  of  all 
men,  telling  him  all  about  it,  how  it  happened,  what 
it  feels  like,  why  they  did  it :  looking  to  him,  right 


HOSPITAL   LIFE  21 

away,  for  advice  and  physic.  They  are  no  two  of 
them  quite  aUke :  and  their  records,  laid  before  i 
him,  range  through  every  intermediate  shade  from 
purest  white  to  a  nauseating  black.  He  begins  to  ^ 
see  that  he  has  more  to  learn  than  the  use  of  a 
stethoscope :  he  must  learn  lives.  The  problem  of 
lives  exalted,  or  sunk,  or  messed  away,  knocks  at 
his  heart.  Let  other  young  men  write  lurid  little 
books,  and  tear  the  veil  from  the  obvious,  and  be 
proud  of  that  achievement :  what  are  they  to  him, 
who  entertains  daily,  as  a  matter  of  course,  both 
Hell  and  Heaven  ? 

I  say  that  he  sees  things  as  they  are ;  but  I  do 
not  say  that  he  puts  a  right  interpretation  to  all 
that  he  sees.  At  first,  I  think,  he  is  apt  to  look 
too  hard  at  the  dark  side.  There  are  times  when 
all  London  seems  to  him  rotten  with  the  contagious 
diseases  and  sodden  with  drink,  a  city  as  gross  and 
vulgar  as  Rome  under  Nero  ;  and  down  with  a  crash 
come  Faith,  Hope,  and  Charity,  and  he  reads  the 
universe  as  a  bad  job,  and  half  wonders  what  is  the 
good,  in  such  a  world,  of  being  good.  That  is  the 
shock  of  coUision  with  things  as  they  are  :  and  you 
may  hear  him  quoting,  Hell  was  a  city  very  much  like 
London.  But  the  bright  side,  the  courage  and  pa-^ 
tience  of  the  majority  of  his  guests,  their  courtesy, 
their  honour,  their  humour,  are  always  before  him  :  . 
which  may  help  him  to  set  up  again,  on  stronger 
pedestals,  these  three. 


22  CONFESSIO   MEDICI 

He  works  under  the  guidance  of  his  seniors,  and 
refers  some  of  his  perplexities,  but  not  all,  to  them, 
and  is  but  a  point  in  a  system.  He  cannot  feed  the 
hungry,  but  he  can  give  them  cod-liver  oil,  and,  if 
the  Hospital  can  afford  it  for  out-patients,  maltine; 
and  he  knows  how  to  get  at  the  Samaritan  Fund. 
He  cannot  clothe  the  naked ;  but  he  can  tell  the 
drunkards  not  to  drink  the  shirts  off  their  backs. 
Poor  himself,  he  enjoys  the  exercise  of  hospitality, 
and  his  alms  and  kind  acts  are  of  singular  felicity. 
His  acquaintance  with  his  guests  is  off-hand,  but 
fairly  accurate  so  far  as  it  goes :  he  has  wide  generic 
names  for  them,  Polly,  Tommy,  Granny,  Daddy, 
and  for  the  immigrant  alien  the  vague  title  of 
Abraham.  Not  all  deserve  his  compassion,  and  it 
is  his  duty  to  tell  some  what  he  thinks  of  them,  for 
he  sees  parents  dead-drunk,  girls  beaten  by  the  men 
who  live  on  their  shame,  and  children  dying  of 
neglect :  he  is  bound  to  rage,  not  grin,  over  such 
cases.  But,  if  he  rages,  it  is  to  good  purpose  ;  if  he 
chaffs,  it  is  taken  in  good  part  :  and  the  voluble 
lady,  sipping  his  well-meant  pint  of  mild  tonic  on 
the  Hospital  steps,  calls  him  a  nice  young  chap,  and 
advises  the  neighbourhood  to  be  sure  they  have  him, 
next  time  they  go  there. 

In  the  wards,  where  quiet  and  order  reign,  he 
has  further  opportunities  for  insight,  and  for  more 
deliberate  observation.  He  learns,  with  higher 
exactness,  to    trust    and    to  distrust    himself,  to  be 


HOSPITAL   LIFE  23 

slow  to  find  fault  with  other  men  and  quick  to 
help  them  :  he  becomes  acquainted  with  heavy 
responsibility,  with  the  full  bitterness  of  a  bad 
mistake,  the  full  delight  of  pulling  people  out  of 
death's  way.  He  begins  to  be  able  to  read  characters, 
and  to  see,  by  the  scars  on  the  lives  allotted  to  his 
care,  what  havoc  we  make  of  our  chances. 

Finally,  if  he  obtains,  when  he  is  qualified,  the 
office  of  a  Flouse-physician  or  a  House-surgeon,  he 
has  a  time  so  happy,  so  rich  in  friendship,  advance- 
ment, and  experience,  that  he  hates  the  day  when 
he  must  say  goodbye  to  the  Hospital.  Deus  in 
medio  ejus,  says  he ;  non  co?mnovebitur.  Years  ago, 
he  brought  his  gifts  to  the  shrine,  and  they  were 
accepted :  and  the  spirit  of  the  place  has  approved 
his  long  and  faithful  service. 

Contrast,  with  these  crowded  years,  the  narrow 
outlook  and  bookish  studies  of  young  men  reading 
for  the  Bar,  or  for  the  Civil  Service :  who  have  no 
Hospital,  and  entertain  nobody.  Or  look  away, 
from  the  sleepless  energy  of  a  great  Hospital,  to 
the  emptiness  of  the  City  after  office-hours,  and 
the  wastes  of  South  Kensington  from  Saturday  to 
Monday.  There  is  not  one  profession  that  we 
need  envy :  for  there  is  none  that  gives  to  its 
students  such  a  good  introduction  to  things  as 
they  are. 

I  have  attributed  to  my  imaginary  student  a 
more    emotional     temperament     than    the     public 


24  CONFESS lO   MEDICI 

admires  In  Its  doctors ;  for  I  wanted  to  say,  as  clearly 
as  I  could,  that  a  great  Hospital  is  something 
more  than  a  big  machine.  All  the  same,  the  public 
is  right :  emotional  students  do  not  make  successful 
practitioners.  A  man  of  sentiment :  well,,  there  is 
nothing  in  the  world  so  noble  as  a  man  of  sentiment,, 
says  Sir  Peter  Teazle.  Then,  down  comes  the 
screen,  and  he  changes  his  mind :  If  you  have  any 
regard  for  me,,  never  let  me  hear  you  utter  anything 
like  a  sentiment.  So  says  the  public,  when  it  is  ill, 
really  ill,  to  the  practitioner. 

Now  that  I  have  mentioned  the  practitioner,  I 
must  end  and  sum  up  this  discourse  de  Religione 
Discipuli.  Every  student  ought  to  bring  to  the 
service  of  his  Hospital  the  gifts  of  a  good  dis- 
position, a  good  home,  and  a  good  public  school. 
He  need  not  bring  gifts  which  will  hardly  be 
wanted :  the  spirit  of  the  place  is  a  rustic  deity, 
caring  little  for  elaborate  offerings.  He  should 
love  the  Hospital  life ;  remembering,  that  it  is 
likely  to  be  changed.  Tribal  worship,  rival  shrines, 
and  all  such  paganism,  must  reckon  with  the 
University  of  London,  whose  faith  hath  centre 
everywhere.  Already,  In  the  teaching  of  the 
threshold  sciences,  this  change  is  beginning:  and 
the  time  may  come  when  it  shall  be  said,  on  ;behalf 
of  medical  education,  that  even  for  clinical  teaching 
the  Hospitals  of  London  ought  to  work  together, 
abandon  competition,  break   their  distinctive  idols. 


HOSPITAL   LIFE  25 

throw  open  their  sacred  groves,  and  pool  their 
patients.  That  would  be  a  new  version  of  the 
story  of  Bethesda :  and  the  waters  of  that  pool 
would  indeed  be  troubled.  A  Hospital  patient  has 
no  desire  to  be  associated  with  any  body  but  his 
own.  He  likes  the  ofF-hand,  homely,  old-fashioned 
kindliness  of  a  good  Hospital  :  he  makes  a  friend 
or  two,  and  keeps  them.  Of  us,  who  entertain 
him,  it  may  be  for  a  day,  it  may  be  for  months, 
he  is  of  opinion  that  we  are  a  very  decent  lot, 
especially  Sister.  He  does  not  always  admire  us 
all :  but  he  would  not  care  to  be  run  by  the 
London  County  Council,  or  by  the  Labour  Party ; 
and  I  agree  with  him.  In  medical  education,  let 
us  welcome  loyally  any  change  that  will  help  us 
to  do  more  for  our  patients  :  but  let  us  hold  fast  to 
the  unity  of  Hospital  life,  and  to  our  bounden 
duty  to  the  spirit  of  the  place. 


AN    ESSAY    FOR   STUDENTS 

I  DARE  to  preach  to  students,  for  this  reason,  that 
they  preach,  so  many  of  my  juniors,  to  me.  One 
by  his  love  of  practice,  another  by  his  love  of 
science ;  one  by  his  confidence,  another  by  his 
diffidence ;  one  by  what  he  can  do,  another  by 
what  he  can  do  without.  Now  it  is  my  turn. 
I  want  to  say  what  I  think  about  Psychology.  I 
believe  that  many  students,  by  a  loose  and  off-hand 
notion  of  Psychology,  do  themselves  more  harm 
than  good,  and  go  into  practice  believing  what  is 
not  true.  Illogical  talk  drifts,  like  a  mist,  through 
Hospital  life,  all  tending  to  deny  that  the  word 
Psyche  means  anything.  I  hate  that  sort  of  talk. 
If  this  Confessio  Medici  is  to  be  of  any  use  to 
students,  it  will  be,  I  hope,  here,  in  this  essay  on 
Psychology. 


I  sit  at  my  writing-table,  and   see,  through  the 

window,  a    beggarly    strip    of  grey    sky,     and    the 

backs  of  some  houses,  and  the  flickering  leaves  of 

26 


AN   ESSAY   FOR   STUDENTS  27 

a  tree  round  the  corner.  I  hear  the  sound  of 
bricklayers  at  work  on  my  neighbour's  premises  : 
and  now  and  again  a  motor  hoots.  The  furniture 
of  the  room,  so  famihar  that  it  seems  thought-worn, 
is  of  such  and  such  colours  and  shapes.  A  moment 
ago,  I  hardly  noticed  my  surroundings  :  now,  they 
are  asserting  themselves.  Light  and  outline  and 
contrast  and  contact  are  appealing  to  me,  bidding 
for  recognition,  elbowing  their  way  to  me,  throwing 
themselves  at  my  head :  and  in  at  the  window 
comes  a  new  legion  of  auxiliary  sounds,  of  rain, 
and  a  piano  somewhere,  and  far-off  traffic.  I  feel 
like  a  theatre  when  the  doors  open,  and  the  queues 
are  admitted  to  pit  and  gallery.  I  am  fiUing-up 
quick  :  and  it  only  needs  the  smell  and  the  taste 
of  a  cigarette,  or  a  mouthful  of  food,  to  occupy  the 
reserved  seats.  There,  1  have  lighted  a  cigarette  : 
and  now  my  senses  can  say,  with  proper  pride. 
House  Full:  Standing  Room  Only.  The  use  of  such 
a  notice  is  many  centuries  old :  for  there  is  in  the 
British  Museum  a  stone  slab,  with  holes  bored  in 
it  for  immediate  hoisting — Circus  Plenus,  Clamor 
Ingens.  That  is  the  present  state  of  my  mind. 
Circus  Plenus.  The  doors  opened,  and  the  external 
world  came  in  :  and  that,  not  disorderly  but  orderly, 
with  all  pomp  and  circumstance  of  reality,  wealth 
of  incident,  and  majesty  of  association. 

External,  I   call  the  world :   it  is    a    strange  ad- 
jective.     My  hand,  as   I   sit  here  writing,  holds  a 


28  CONFESSIO   MEDICI 

wooden  penholder,  and  rests  on  a  table  which  is 
covered  with  a  green  cloth.  The  penholder,  of 
course,  is  a  part  of  the  external  world :  but  how 
about  my  hand  ?  Looking  at  the  two  implements, 
and  observing  how  they  work  together,  I  do  not 
see  that  the  one  is  more  external  than  the  other. 
I  separate  them,  and  lay  them  on  the  table,  side 
by  side,  a  few  inches  apart ;  I  join  them  again, 
and  use  them  as  one  implement,  part  made  of 
wood,  part  made  of  hand.  I  find  no  evidence  that 
the  external  world  stops  at  my  enveloping  skin,  at 
the  exact  plane  where  my  pen  and  my  hand  are 
in  contact.  Likewise,  when  I  have  my  hair  cut, 
the  hair  which  stays,  on  the  near  side  of  the  scissors, 
is  just  as  external  as  the  hair  which  falls,  on  the  far 
side  of  the  scissors.  Or  take  these  three  cases. 
A  had  his  leg  amputated :  the  surgeon  removed, 
but  did  not  externalize,  the  leg.  They  buried  it 
in  the  garden ;  and  A,  when  he  got  on  crutches, 
went,  for  his  first  walk,  to  its  graveside  :  it  was  still, 
he  said,  his  leg.  B  swallowed  a  sixpence :  he  made 
a  good  recovery,  so  good  that  it  included  the 
recovery  of  the  sixpence,  which,  of  course,  had 
been  external  to  him  all  the  time.  C  died  of  drink  : 
it  wrought  the  usual  changes  in  his  tissues  :  it  could 
not  have  got  at  them,  unless  they  had  been  just 
as  external  as  itself  Once  we  begin  to  talk  as  if 
the  external  world  were  outside  our  skins,  there  is 
no  end  to  casuistry. 


AN   ESSAY   FOR   STUDENTS  29 

But  let  us  take  some  object  which  is  wholly 
extra-corporeal.  To  me,  at  this  moment,  the  ex- 
ternal world  offers,  as  a  sample  of  its  wares,  this 
green  tablecloth  here  under  my  hand.  Here  is  a 
miracle  indeed,  and  a  whole  legion  of  them  :  for 
there  is  no  other  or  greater  in  the  universe  than 
I  may  find  in  this  bit  of  serge.  It  was  the  fashion, 
when  I  was  a  child,  for  our  teachers  to  show  us 
familiar  objects  under  the  microscope.  A  needle- 
end  looking  like  a  poker,  a  flea  looking  like  a 
night-mare,  enlarged  our  minds  by  their  own 
enlargement ;  and  wonder,  like  beauty,  drew  us 
by  a  single  hair.  We  examined  the  dust  off  a 
butterfly's  wing,  and  behold,  it  was  a  myriad  of 
scales  delicately  shaped  and  ribbed  like  palm-leaf 
fans ;  or  we  saw  in  a  drop  of  blood  the  rouleaux 
of  red  corpuscles  :  and  were  amazed,  but  there  we 
stopped,  not  wondering  how  these  facts  of  the 
external  world  found  their  way  to  us.  And,  I 
think,  we  were  tempted  to  believe  that  we  had 
somehow  accounted  for  Nature  by  magnifying  her 
belongings ;  and  that  nothing  remained  to  be  said, 
when  we  had  seen  what  the  microscope  had  to  say. 
The  real  excitement,  of  course,  begins  where  the 
microscope  leaves  off.  Imagination  divides  a  speck 
of  dust  into  its  component  parts,  and  each  of  these 
into  its  component  parts,  and  so  on,  till  we  go  over 
the  edge  of  thought,  still  thinking  of  that  which  is 
divisible  ;  the  microscope  cares  only  for  the  evidence 


30  CONFESSIO   MEDICI 

of  its  own  eyes,  and  takes  no  interest  in  the  mere 
fact  that  objects  are  visible. 

This  tablecloth,  what  is  it  ?  How  does  it  con- 
trive to  enter  into  my  life  and  stay  there  ?  What 
has  happened,  that  here  is  a  tablecloth  ?  I  cannot 
hope  to  find  the  right  answer,  or  any  answer,  to 
these  questions,  unless  I  approach  them  in  the  proper 
spirit.  Here,  between  my  finger  and  thumb,  is  all 
that  anything  material  has  been,  or  is,  or  ever  will 
be.  If  I  can  understand  this  fold  of  stuff,  I  can 
understand  the  stars.  We  need  not  look  at  large 
objects  a  long  way  off,  when  we  want  to  philoso- 
phize :  the  universe  should  be  studied  not  in  bulk 
but  in  sample.  It  follows,  that  I  must  reverence  in 
this  cloth,  or  in  a  single  thread  of  its  fabric,  all 
those  immensities  and  eternities  which  I  reverence 
in  the  universe,  or,  as  the  fashion  is  to  call  it,  the 
cosmos,  which  is  a  very  inferior  word.  If  the 
heavens  declare  the  glory  of  God,  so  does  the  table- 
cloth :  if  it  does  not,  neither  do  they.  I  will  go 
down  on  my  knees  before  it,  and  stay  there. 

Kneeling  to  these  unconsecrated  elements  of  warp 
and  woof,  I  begin  to  think  that  I  see  where 
Psychology  has  gone  wrong.  She  is  so  anxious  to 
be  a  complete  science,  that  she  refuses  to  be  sur- 
prised at  the  universe  :  she  affects  the  cold  matter- 
of-fact  demeanour  of  the  sciences  which  are  complete. 
They  cut  me,  they  cut  me  dead,  these  sciences,  they 
fix  a  vacant    stare,  and  slay  me   with    their    noble 


AN   ESSAY   FOR   STUDENTS  31 

birth :  and  Psychology,  that  she  may  get  into  their 
set,  imitates  them.  It  is  not  their  way,  to  wonder 
that  the  universe  is  here  :  they  are  sure  that  nothing 
in  Nature  is  unnatural,  and  that  the  infinite  is  only 
the  rest  of  the  finite.  Chemistry  is  not  surprised 
when  salt  dissolves  in  water,  nor  Botany  when  a  bulb 
turns  into  a  hyacinth,  nor  Biology  when  an  egg, 
discarding  its  original  design  for  a  pair  of  gills,  turns 
into  a  chicken.  They  would  be  ashamed,  these 
quiet  gentlewomen,  of  gasping  and  exclaiming  over 
normal  phenomena  :  they  never  forget  themselves 
in  Ohs  andAhs,  like  the  crowd  at  the  Crystal  Palace 
when  the  rockets  explode.  Therefore  Psychology, 
that  she  may  be  admitted  to  their  circle,  apes  their 
tone. 

She  insists  on  it,  that  she  is  a  science.  In  vain 
the  wisest  of  her  servants.  Professor  James,  tells  her 
that  she  is  not :  and  that,  of  all  places,  in  his  Text- 
book of  Psychology.  His  first  words  to  her,  on 
page  I,  are  to  the  effect  that  she  is  not  a  science: 
and  his  last  words,  on  page  468,  are  to  the  same 
effect.  He  begins  by  shaking  the  dust  of  her  house 
off  his  feet:  and  he  ends  by  shaking  them  again,  to 
make  sure.  On  page  i,  he  calls  her  a  provisional 
beginning  of  learning,  and  says  that  she  must  stick 
to  her  own  arbitrarily  selected  problems,  and  ignore 
all  others.  "  Psychology,'*  he  says  on  page  2,  "  as  a 
natural  science,  deals  with  things  in  a  partial  and 
provisional    way.       In    addition     to    the    'material 


32  CONFESSIO   MEDICI 

world/  which  the  other  sciences  of  nature  assume, 
she  assumes  additional  data  peculiarly  her  own,  and 
leaves  it  to  more  developed  parts  of  Philosophy  to 
test  their  ulterior  significance  and  truth."  On 
page  468,  the  last  page  of  all,  he  fairly  lets  himself 
go.  "  This  is  no  science,  it  is  only  the  hope  of  a  science. 
The  matter  of  a  science  is  with  us.  Something 
definite  happens  when  to  a  certain  brain-state  a 
certain  'sciousness'  corresponds.  A  genuine  glimpse 
into  what  it  is  would  be  the  scientific  achievement, 
before  which  all  past  achievements  would  pale. 
But,  at  present,  psychology  is  in  the  condition  of  physics 
before  Galileo  and  the  laws  of  motion,  of  chemistry 
before  Lavoisier  and  the  notion  that  mass  is  pre- 
served in  all  reactions.  The  Galileo  and  the 
Lavoisier  of  psychology  will  be  famous  men  indeed 
when  they  come,  as  come  they  one  day  surely  will, 
or  past  successes  are  no  index  to  the  future.  When 
they  do  co?ne,  however,  the  necessities  of  the  case  will 
make  them  ' metaphysical'  " 

The  itahcs,  I  am  proud  to  say,  are  mine.  And 
there  the  book  ends,  with  a  final  warning  to 
Psychology  that  her  assumptions  are  provisional 
and  revisable,  and  that  she  is  groping  in  great 
darkness  :  and  nothing  is  left  to  be  read  but  the 
index,  and  the  slip  from  the  Times  Book  Club, 
with  the  good  news  that  I  can  buy  all  this  wisdom 
in  Class  B  for  less  than  it  is  worth.  For  I  love 
a  text-book   of  Psychology  which  begins  and  ends 


AN   ESSAY   FOR   STUDENTS  33 

with  the  assurance  that  I  need  not  be  frightened, 
though  the  experimental  psychologists  furiously 
rage  together,  and  imagine  a  vain  thing.  Professor 
James  is  like  Jehu.  Psychology  paints  her  face, 
and  tires  her  head,  and  looks  out  of  the  window : 
and  Throw  her  down^  says  he,  and  treads  her  under 
foot.  Then,  when  he  has  gone  in,  and  has  eaten 
and  drunk  in  the  house  of  Philosophy,  Go,  says 
he.  See  now  this  cursed  woman^  and  bury  her :  for 
she  is  a  King's  daughter:  and  they  go,  and  find 
no  more  of  her  than  the  skull,  and  the  feet,  and 
the  palms  of  the  hands. 

She  assumes  the  material  world.  It  has  an 
inverted  comma  on  either  side  of  it,  and  she 
assumes  it  in  spite  of  those  warning  signals.  She 
assumes,  also,  certain  additional  data  peculiarly  her 
own,  which  have  not  had  their  ulterior  significance 
tested,  nor  their  truth.  Who  told  her  that  she 
might  do  that  ?  Who  gave  her  those  data  ?  If 
nobody  gave  them  to  her,  if  she  simply  took  them, 
in  what  sense  are  they  her  own?  I  might  assume, 
provisionally,  the  name  of  John  Sebastian  Bach : 
but  would  it  be  my  name  ?  And  what  is  the 
difference,  if  any,  between  the  ulterior  significance 
of  a  datum,  and  its  truth  ?  Or  between  ulterior 
significance  and  any  other  sort  of  significance  }  And 
what  measure  of  faith  do  we  owe  to  the  hope  of 
a  science  ? 

At  -present^  Psychology  is  in  the  condition  of  physics 


34  CONFESSIO    MEDICI 

before  Galileo.  That  is  a  blessed  sentence  ;  and  I 
will  have  it  framed  and  glazed,  and  hung  where 
I  can  lie  in  bed  and  look  at  it,  next  time  I  am 
ill.  It  is  a  great  help,  it  leaves  the  mind  so  free, 
to  have  such  a  text  before  the  eyes.  Even  more 
soothing  is  the  promise  that  future  psychologists, 
who  will  really  know  what  Psyche  is  —  alas,  I  shall 
not  live  to  see  that  day  —  will  be,  by  the  necessities 
of  the  case,  philosophers.  There  they  are,  that 
angelic  host,  the  necessities  of  the  case.  Far  above 
the  additional  data  which  have  not  yet  been  tested, 
and  the  great  darkness  in  which  this  unscientific 
science  gropes,  the  necessities  of  the  case  stand 
and  wait.  What  will  they  do,  what  will  they  not 
do,  in  that  day  of  Armageddon  when  they  shall 
take  Psychology  seriously  in  hand  ? 

Suppose  that  I  ordered  a  coat,  a  bicycle,  and  a 
watch,  and  that  each  of  them  arrived  piecemeal,  a 
loose  lot  of  parts  ;  the  coat  cut-out  but  not  sewn 
together,  the  bicycle  in  three  packing-cases,  the 
watch  a  disconnected  handful  of  bits  of  machinery. 
With  the  coat,  this  letter  —  Please  to  kindly  regard 
this  consignment  as  provisional  andrevisable.  We  are 
forwarding  to  you  the  data  of  your  coat^  as  per 
esteemed  order.  Their  ulterior  significance  must  be 
tested  by  some  more  developed  firm.  This  is  not  a 
coat^  it  is  only  the  hope  of  a  coat.  We  send  you  the 
matter  of  a  coat^  something  definite^  which  has  happened: 
but  we  regret  that  we  have  not  been  able  to  obtain 


AN   ESSAY   FOR   STUDENTS  35 

a  genuine  glimpse  into  what  it  is.  When  we  do,  you 
will  be  pleased  to  find  that  the  coat,  by  the  necessities 
of  the  case,  will  put  itself  together.  Hoping  for  the 
continuance  of  your  valuable  patronage,  —  Such  a  letter 
would  make  me  think  that  tailoring  is  not  an 
art,  any  more  than  Psychology  is  a  science,  for  all 
her  assumptions. 

Not  that  her  assumptions,  of  themselves,  matter 
twopence,  one  way  or  the  other.  It  is  the  use 
that  she  makes  of  them,  which  matters.  Assump- 
tions are  honourable,  or  dishonourable,  according 
to  their  intention.  If  I  had  to  attend  a  fancy- 
dress  ball,  which  Heaven  forbid,  I  should  go  as  a 
Gentleman  of  the  time  of  Charles  the  Second. 
That  would  be  all  right.  I  should  assume  the 
appropriate  clothes,  and  a  long  peruke.  Nobody 
would  be  deluded,  or  unduly  impressed :  nobody 
would  think  that  I  was  really  of  that  period.  I 
must  go  as  something,  or  I  cannot  go  at  all.  But 
suppose  that  I  assume,  in  the  corner  of  a  cheque, 
the  signature  of  a  rich  friend.  How  will  it  fare 
with  me  and  my  honour,  when  the  ulterior  signifi- 
cance of  that  assumption  is  tested  by  the  cashier 
at  the  Bank  ?  And  I  make  bold  to  say  that 
Psychology,  or,  at  any  rate,  a  certain  talkative  lady 
who  calls  herself  by  that  name,  is  not  very  scrupu- 
lous what  she  assumes,  nor  very  careful  of  her 
honour.  She  longs  to  be  a  science,  to  move  in  the 
best  circles,  in  a  set  not  her  own,  in  the  drawing- 


36  CONFESSIO   MEDICI 

rooms  of  those  old  peeresses,  the  Complete  Sciences. 
To  get  there,  she  must  push  and  pose,  and  be 
hard,  pretentious,  in  a  word,  unprincipled.  Watch 
her,  hinting,  cajoling,  fighting  her  way  into  their 
society,  and  you  will  be  reminded  of  Mrs.  Rawdon 
Crawley,  who  was,  you  remember,  Becky  Sharp, 
in  the  company  of  Lady  Steyne,  Lady  Jane  Crawley, 
and  the  Dowager  Countess  of  Southdown.  And 
we  all  know  what  happened  to  Becky,  when  her 
husband  was  compelled,  by  the  necessities  of  the 
case,  to  test  her  ulterior  significance. 


II 

Still,  we  hear  so  much  of  the  Principles  of 
Psychology,  that  we  are  bound  to  try  to  find 
them.  But  what  do  we  mean,  by  this  word 
Principles  ? 

When  a  man  sets  to  work  to  study  one  of  the 
natural  sciences,  he  provides  himself  with  forms  of 
thought,  mental  images,  which  may  be  called  the 
principles  of  that  science.  The  chemist  has  mental 
images  of  atoms  combining  or  separating,  under 
definite  laws,  with  definite  results :  the  geologist 
has  mental  images  of  an  earth  cooled  through 
millions  of  years  from  a  red-hot  haze  of  gases 
to  a  hard  globe,  and  cracked  in  the  cooling.  Other 
men  of  science,  the  botanist,  the  bacteriologist,  the 
physiologist,  have  mental  images  of  living  matter. 


AN   ESSAY   FOR   STUDENTS  37 

Is  there  any  difference,  in  kind,  between  the  mental 
images  of  chemistry  and  those  of  physiology  ? 
Surely,  there  is  no  such  difference.  Matter  is  none 
the  less  matter,  though  it  be  Hving  :  and  motion 
is  none  the  less  motion,  though  it  be  voluntary. 

Dr.  Johnson's  advice  is  apt  here,  that  we  should 
clear  our  minds  of  cant.  A  great  deal  of  cant  is 
talked  about  the  mystery  of  life,  as  if  life  were 
somehow  more  mysterious  than  the  rest  of  Nature. 
When  a  man  says  that  one  fact  of  Nature  is  more 
wonderful  than  another,  he  is  at  fault.  The  striking 
of  a  match  is  every  bit  as  wonderful  as  the  working 
of  a  brain  :  the  union  of  two  atoms  of  hydrogen 
and  one  of  oxygen  in  a  molecule  of  water  is  every 
bit  as  wonderful  as  the  growth  of  a  child.  Nature 
does  not  class  her  works  in  order  of  merit ;  every- 
thing is  just  as  easy  to  her  as  everything  else : 
she  puts  her  whole  mind  into  all  that  she  does  — 

Lives  through  all  life,  extends  through  all  extent. 
Spreads  undivided,  operates  unspent  — 

perfect  at  every  moment,  omnipresent,  and,  like 
His  Majesty  the  King,  within  her  dominions 
supreme.  Life  is  neither  more  nor  less  mysterious 
than  the  attraction  of  the  magnet,  the  density  of 
a  paving-stone,  or  the  colour  of  a  tie  :  our  presence 
in  the  midst  of  Nature's  achievements  does  not 
affect  her  estimate  of  them.  She  prices  her  wonder- 
ful goods  all  at  the  same  value,  like  the  stock  of 
a   sixpence-halfpenny    bazaar,    nothing    under    and 


38  CONFESSIO   MEDICI 

nothing  over :  she  makes  them  all  out  of  the  one 
stuff,  constructing  with  it  a  grain  of  sand,  a  drop 
of  water,  a  micro-organism,  or  a  nerve-cell,  all  with 
equal  ease.  In  brief,  all  Nature  is  of  the  same 
nature,  all  her  processes  are  one  process,  all  her 
facts  are  one  fact,  all  her  acts  are  one  act,  and 
everything  material  is  ultimately  identical  with 
everything  else.  These  platitudes,  of  course,  are  of 
a  respectable  age  :  they  are  no  more  than  the  doctrine 
of  Thales  of  Miletus,  who  lived,  if  I  remember 
right,  six  hundred  years  before  our  Lord.  Arm- 
in-arm  with  Thales,  I  wonder  at  the  mystery  of 
the  fabric  of  my  own  brain  as  I  wonder  at  the 
mystery  of  the  fabric  of  a  pound  of  butter ;  and 
I  take  it  for  granted,  that  the  forces  which  animate 
my  tissues  are  just  as  natural,  that  is  to  say,  are 
just  the  same,  as  the  forces  which  animate  the 
tissues  of  an  ape,  a  frog,  an  oyster,  or  a  dandelion, 
and  thrill  in  every  grain  of  sand,  and  compel  two 
atoms  of  hydrogen  and  one  of  oxygen  to  clutch 
each  other  so  close  that  they  are  neither  hydrogen 
nor  oxygen,  nor  hydrogen  -plus  oxygen,  but  water. 

Hitherto,  I  have  said  what  I  believe  to  be  true. 
Now,  I  am  going  to  say  what  I  believe  to  be  false. 
I  pray  you,  therefore,  to  give  me  your  most  careful 
attention. 

When  we  strike  a  match,  there  is  a  splutter  and 
a  flare,  which  are  the  atoms  of  the  match  and  of 
the  atmosphere  performing  a    new  sort   of  dance. 


AN  ESSAY  FOR   STUDENTS  39 

Nothing  is  added  to  what  was  already  there ;  no 
fresh  elements  or  forces  arrive  on  the  gay  scene. 
The  atoms  are  the  explosion,  and  the  explosion  is 
the  atoms.  They  hurry  up,  they  change  step,  they 
exchange  partners :  that  is  all.  Before  we  struck 
the  match,  they  were  dancing,  as  it  were,  the  second 
figure  of  the  Lancers ;  now,  they  are  dancing  the 
third  figure,  pulling  and  pushing  in  that  hilarious 
fashion  which  is  called  Kitchen-Lancers :  that  is  all. 
Even  so  it  is,  with  consciousness.  When  something 
strikes  us,  there  is  a  splutter  and  a  flare,  which  are 
the  atoms  of  our  cerebral  cells  performing,  in  the 
crowded  ball-room  of  the  brain,  a  new  sort  of  dance ; 
and  that  is  all.  That  dance  is  consciousness,  and 
consciousness  is  that  dance.  Consciousness  is  neither 
the  music  which  accompanies  the  dance,  nor  the 
reaction  which  follows  the  dance :  it  is  the  dance, 
it  is  atoms  in  motion.  Of  course,  to  dance  this 
particular  figure,  the  atoms  must  be  accustomed  to 
dancing,  and  there  must  be  enough  of  them  to  make 
up  a  set,  so  many  ladies  and  so  many  gentlemen : 
and  then  they  can  dance  till  they  are  tired,  and  that 
dance  is  consciousness.  But,  we  know,  it  is  possible 
to  dance  less  than  sixteen  :  indeed,  a  child  will  dance 
all  alone,  without  so  much  as  a  barrel-organ.  Even 
so  it  is,  with  consciousness.  In  its  simplest  form, 
consciousness  may  be  observed  even  in  very  humble 
structures.  As,  by  putting  a  penny  in  the  slot,  we 
obtain,  if  the  automatic  machine  be  going,  a  measured 


40  CONFESSIO  MEDICI 

projection  of  chocolate  or  of  scent,  or  of  two  foreign 
bodies  called  cigarettes,  or  an  electric  current,  or  the 
exhibition  of  a  moving  picture,  or  the  liberation  of 
a  balance,  so,  from  the  amoeba,  if  it  be  going,  we 
get  something  out,  some  faint  consciousness,  a  mere 
glimmer ;  still,  it  is  the  real  article,  what  there  is  of 
it.  When  we  stand  in  the  presence  of  nobler 
creatures,  such  as  the  oyster,  we  see  movements 
more  definitely  purposive ;  and  begin  to  feel  fairly 
sure  that  the  sun  of  consciousness  has  risen.  We 
are  for  a  time  puzzled,  because  the  oyster  has  several 
centres  set  apart,  and  far  apart,  for  consciousness ; 
and  it  is  hard  to  see  how  an  oyster  can  be  conscious 
in  three  or  four  places  at  once :  and  this  difficulty 
is  not  diminished,  but  rather  is  increased,  when  we 
contemplate  the  earth-worm,  which  is  a  sort  of 
common  lodging-house  of  consciousness,  with  a 
double  row  of  cubicles  right  and  left  all  the  way 
up.  But,  when  we  come  to  the  frog,  we  know 
where  we  are :  for  we  can  see  at  a  glance  that  the 
cerebral  hemispheres  must  be  conscious  of  the  rest 
of  the  frog,  and  that  the  rest  of  the  frog  cannot  be 
conscious  of  the  cerebral  hemispheres.  Here,  at  or 
about  this  level  of  life,  we  find  special  organs,  brains, 
so  complex  that  they  must  of  necessity  be  conscious. 
But  of  what  are  they  conscious  ?  Is  it  of  themselves, 
of  their  own  atomic  motion,  their  own  chemical 
changes  ?  Not  a  bit  of  it :  they  are  conscious  of 
sensations,  dim  pleasures  and  pains,  heat  and  cold;^ 


AN  ESSAY  FOR   STUDENTS  41 

light  and  darkness,  taste  and  smell.  They  feel,  they 
perceive.  From  this  point  onward,  it  is  easy  to 
observe  the  development  of  consciousness ;  the  brain, 
as  we  ascend  the  scale  of  life,  beginning  to  divide  its 
experiences  into  self  and  not-self.  At  first,  it  was 
conscious  :  at  last,  it  is  self-conscious.  Henceforth, 
it  remembers,  imagines,  thinks,  and  wills,  or  thinks 
that  it  wills.  It  reads  and  writes,  pursues  the  fine 
arts,  invents  God,  takes  an  active  interest  in  politics, 
and,  if  it  be  lodged  in  a  male  skull,  has  a  vote. 
Behold,  Gentlemen,  yourselves :  you  who  are  so 
highly  differentiated  brains  that  you  can  understand 
anything,  even  the  false  doctrine  which  I  have  here 
declared  to  you.  For  I  no  more  believe  that  my 
brain  is  self-conscious  than  I  beHeve  that  two  and 
two  make  five.  All  the  same,  it  was  a  fair  caricature 
of  the  random  talk  which  calls  itself  Psychology. 


Ill 

Let  us  start  again,  at  the  right  end  of  creation, 
at  ourselves.  If  we  desire  to  find  the  Principles  of 
Psychology,  it  seems  not  amiss  that  we  should  first 
look  for  them  there,  where  Psyche  and  Logos  are 
most  in  evidence.  Besides,  we  know  more  of  our- 
selves than  of  the  lower  animals. 

Let  us  bring  Science  to  bear  on  our  environment. 
There  cannot  be  any  harm  in  doing  that.  Here,  at 
this  moment,  I  still   reading  this  essay  to  you,  and 


42  CONFESSIO   MEDICI 

you,  it  may  be,  still  listening  to  me,  where  are  we  ? 
This  Common-room,  its  colour,  light,  and  resonance, 
its  temperature,  and  the  smell  of  tobacco,  and  the 
vision  of  your  presence  —  What,  in  the  name  of 
Science,  are  all  these  facts  ?  A  mild  shock  passes 
through  me,  as  I  remind  myself  that  they  are  diverse 
lengths  and  velocities  of  waves  of  air  or  of  ether. 
The  tint  of  the  walls,  the  pattern  of  the  carpet,  the 
warmth  of  the  fire,  the  sound  of  my  voice,  the 
fragrance  of  your  smoking,  the  sight  of  your  faces, 
all  are  waves,  of  which  I  know  nothing,  agitating 
an  invisible  something,  of  which  I  know  less  than 
nothing.  Colour  is  so  many  waves  a  second,  heat 
so  many  more,  sound  so  many  more.  Neither  do 
I  find  in  the  furniture  and  upholstery,  or  in  the 
hardness  of  this  desk  in  front  of  me,  or  in  the  resist- 
ance of  the  ground  under  my  feet,  or  in  the  mus- 
cular sense  of  my  limbs,  or  in  the  pressure  of  the 
glasses  across  my  nose,  any  other  sort  of  environ- 
ment than  that  which  I  find  in  colour,  warmth,  and 
sound.  In  brief,  this  room  is  the  sum  of  our 
sensations ;  and  our  sensations  are  waves  from  the 
material  world  impinging  on  our  sensory  nerve- 
endings  :  and  the  material  world  is  a  permanent 
possibility  of  consciousness.  That  is  the  teaching 
of  Science.  When  we  take  our  sensory  nerve- 
endings  home  with  us,  what  is  left  of  this  room  ? 
The  answer  seems  to  be,  that  nothing  is  left  but 
a  permanent  possibility  of  consciousness,  impinging 


AN  ESSAY  FOR   STUDENTS  43 

on  nothing.  This,  I  feel  sure,  is  the  only  kind  of 
room  in  which  Science  permits  us  to  hold  our 
meetings. 

But  consider  what  happens  to  these  waves.  They 
strain  through  our  sensory  nerve-endings  like  water 
through  a  sieve,  rush  up  our  nerves,  attain  their 
appointed  places  in  our  cerebral  hemispheres,  and 
there  they  set  our  atoms  dancing.  But,  whatever 
they  do,  they  are  still  waves  :  and,  when  they  stop 
moving,  are  still  a  sort  of  bottled  motion.  Once 
a  wave,  always  a  wave  ;  that  is  the  law  of  the  con- 
servation of  energy  :  and  a  wave  can  no  more  be 
a  sensation  than  a  fiddle  can  be  a  tune.  They  can- 
not translate  themselves :  it  is  we  who  do  that  for 
them.  What  are  they,  apart  from  us  ?  A  tree  is 
not  green,  unless  we  see  it ;  a  man  playing  a 
trombone  makes  no  noise,  unless  we  are  there ; 
there  is  neither  taste  nor  smell  in  our  food,  unless 
it  comes  our  way  ;  and  a  brick  wall  is  not  hard, 
unless  we  hit  our  heads  against  it.  If  I  prick  my 
finger  with  a  needle,  the  pain  is  in  me,  not  in  the 
needle :  if  I  wear  a  grey  coat,  the  grey  is  in  me,  not 
in  the  coat :  and  if  I  hear  a  motor  hooting,  the  hoot 
is  in  me,  not  in  the  motor. 

From  these  elementary  facts,  which  are  the 
commonplaces  of  Science,  we  come  at  last  toward 
the  Principles  of  Psychology.  No,  we  do  not :  we 
only  come  within  ear-shot  of  a  stand-up  fight  between 
two  irreconcileable  modes  of  thought. 


44  CONFESSIO   MEDICI 

Over  chemistry,  geology,  botany,  physiology,  a 
man  cannot  go  wrong.  In  these  Complete  Sciences 
there  is  no  choice  of  principles.  There  cannot  be 
two  mental  images  of  the  earth  :  there  cannot  be  two 
mental  images  of  living  matter.  But  there  are  two 
mental  images  of  Psyche,  two  conflicting  modes  of 
thought,  each  in  arms  against  the  other  :  and  we 
must  choose  between  them,  for  we  cannot  have  it 
both  ways.  Psyche  is,  or  Psyche  is  not :  we  must 
choose,  and  our  choice  is  a  serious  business  for  us, 
and  for  those  who  take  their  cue  from  us.  It  is 
said  that  in  Paris,  all  through  the  Reign  of  Terror, 
there  were  stupid  people,  in  the  quiet  parts  of  the 
city,  who  never  heard  the  tumbrils  on  their  way  to 
the  guillotine,  never  knew  that  anything  more  was 
happening  than  the  usual  discontent,  the  usual  mob- 
oratory.  If  that  be  so,  they  have  their  parallel 
to-day  in  the  stupid  people  who  never  hear  the 
tumbrils  of  Experimental  Psychology,  escorting 
Psyche  on  her  way  to  be  explained  away. 


IV 

That  school  of  Psychology  which  bears,  *mid  snow 
and  ice,  a  banner  with  this  strange  device.  Psyche  is 
not,  oflfers  to  provide  us  with  a  ready-made  mental 
image  of  self-conscious  matter.  The  opposite  school 
offers  us,  to  my  thinking,  a  pleasanter  image ;  which 
is    indeed    that    original    Psyche    in    which    we    all 


AN  ESSAY   FOR   STUDENTS  45 

believed  when  we  were  children.  Give  me  leave 
to  commend  this  pleasanter  image  to  you,  not  in 
the  name  of  tradition  or  sentiment,  but  in  the  name 
of  logic  and  common-sense. 

Take  for  granted  the  primary  miracle,  the  trans- 
lation of  waves  into  sensations.  So  easy,  to  say 
that.  Still,  assume  it :  assume  that  we  have  got 
past  that  miracle,  and  remain  competent  judges  of 
what  comes  next.  What  have  we  gained,  and  where 
do  we  stand  ?  We  have  got  no  further,  we  have 
gained  nothing.  A  chaos  of  sensations  has  replaced 
a  chaos  of  waves  ;  but  that  does  not  help  us  toward 
the  construction  of  the  world  in  which  we  live. 
We  have  substituted  chaos  for  chaos,  and  there  we 
stop.  If  this  world  be  a  world  of  sensations,  it  is 
all  up  with  Psyche,  and  we  must  swear  allegiance 
to  them  who  deny  her  existence. 

But  we  live,  not  by  sensations,  but  by  experiences  : 
not  in  chaos,  but  in  space  and  time.  I  dare  not 
philosophize  about  space  and  time.  I  am  incHned 
to  the  transcendental  doctrine,  that  they  are  in  some 
sense  antecedent  to  experience  and  independent  of 
sensation.  Psychology  says  that  the  baby  begins 
without  them,  and  makes  them  up  as  it  goes  along ; 
but  I  cannot  see  how,  without  them,  it  can  begin 
to  go  along,  or  out  of  what  it  can  make  them  up. 
Our  experiences  cannot  report  themselves  as  in 
space  and  time  ;  for  they  cannot  report  themselves 
at  all,  till  space  and  time  are  there  for  them.     One 


46  CONFESSIO   MEDICI 

might,  perhaps,  have  a  simple  sensation  of  all  red, 
or  all  blue ;  but  one  cannot  have  a  sensation  of 
blue  and  red  side  by  side,  because  neither  can  report 
itself  as  side  by  side  with  the  other.  Blue  and  red 
side  by  side  are  not  a  sensation,  but  an  experience  ; 
and  the  more  you  try  to  imagine  a  baby  apart 
from  its  universe,  or  a  universe  apart  from  its  baby, 
the  less  you  can.  Really,  we  know  very  little  about 
the  baby.  Professor  James,  for  instance,  who  is 
like  Socrates  for  simplicity  of  style,  says : 

The  Object  which  the  numerous  inpouring  currents  of  the 
baby  bring  to  his  consciousness  is  one  big  blooming  buzzing 
Confiasion.      That  confusion  is  the  baby's  universe.    .    .    . 

If  that  was  indeed  my  universe  once,  then  glory 
be  to  Psyche,  for  mxaking  it  what  it  is  now.  I 
cannot  believe,  as  I  look  at  my  present  orderly 
and  beautiful  universe,  that  I  am  a  succession  of 
states  of  consciousness,  or  a  stream,  or  anything 
of  the  kind.  How  a  stream  of  states  of  conscious- 
ness can  be  conscious  of  itself,  conscious  that  it  is 
neither  a  stream  nor  a  state,  when  all  the  time  it 
is  a  state  of  a  stream,  and  therefore  is  not  a  stream 
of  states,  yet  is  a  stream,  and  therefore  is  nothing 
at  all,  yet  is  conscious  of  streaming,  and  therefore 
must  be  something  —  how  all  this  can  mean  any- 
thing, let  them  decide,  to  whom  Psyche  means 
nothing.  Here  is  that  which  is  neither  matter  in 
motion,  nor  sensations  in  chaos,  nor  states  in  succes- 
sion.     It    lives    on    experiences,    which    it  judges, 


AN  ESSAY   FOR   STUDENTS  47 

places,  times,  connects,  compares,  and  remembers. 
It  abides  in  a  flux  of  objects,  all  of  which  it  has, 
none  of  which  it  is.  Out  of  waves,  it  creates  sensa- 
tions ;  out  of  sensations,  experiences  ;  out  of  experi- 
ences, its  proper  life.  Yet  these  achievements  are 
trivial,  compared  to  its  more  active  work.  For 
it  has  a  will  of  its  own.  In  a  world  which  is  all 
made  of  results,  it  still  manages,  somehow,  to  be 
a  cause.  It  is  permanent,  real,  non-material :  I 
never  could  see  why  everything  should  have  to 
be  made  of  matter  to  be  real. 

But  the  animals,  the  lower  animals  ?  Are  we  not 
bound  to  widen  our  conception  of  Psyche  till  it 
includes  all  sentient  life?  In  the  presence  of  the 
lower  animals,  what  becomes  of  all  that  I  have  been 
saying  ? 

I  will  try  to  be  perfectly  honest  here.  Ourselves, 
we  can,  in  some  measure,  understand.  The  moment 
we  leave  ourselves,  all  understanding  begins  to  fail ; 
and  inch  by  inch,  as  we  go  back  down  the  scale 
of  life,  the  darkness  gets  more  impenetrable.  The 
inner  lives  of  animals  are  one  of  Nature's  ultimate 
secrets.  We  can  hardly  guess  at  them,  even  at 
those  which  are  likest  to  us :  we  cannot  imagine 
the  final  reason  why  they  and  we  are  herded  together 
on  this  planet.  Well,  we  must  be  guided  by  what 
we  can  see.  I  must  choose,  it  seems,  between  two 
schools  of  thought.  One,  which  explains  me  in 
terms  of  the    lower    animals,    explains    me    away. 


48  CONFESSIO   MEDICI 

leaving  nothing  but  my  cerebral  hemispheres.  The 
other,  explaining  me  as  I  think  that  I  deserve  to 
be  explained,  evades  the  mystery  of  the  lower 
animals.  I  shall  certainly  die  before  these  two 
schools  are  reconciled.  Meanwhile,  I  choose  that 
school  which  gives  the  best  explanation  of  me  : 
because  I  am  able  to  square  its  teaching  with  my 
knowledge  of  myself 

In  defence  of  my  choice,  I  say  that  Science  is 
just  as  ignorant  as  I  am  of  the  inner  lives  of  the 
lower  animals.  You,  who  are  young  men  of  science, 
I  pray  you  to  imagine  that  our  meeting  is  over 
and  we  have  gone  home,  we  and  our  sensory  nerve- 
endings.  It  is  midnight :  this  room  has  relapsed 
to  a  permanent  possibility  of  consciousness,  a  fact 
which  is  hardly  more  definite  than  a  dream. 
Suddenly,  into  this  abstract  environment,  enter,  by 
chance,  a  mouse  and  a  blackbeetle.  What  do  they 
make  of  it  all  ?  How  does  it  strike  them  ?  What 
is  it,  to  be  a  blackbeetle  ?  When  a  blackbeetle 
enters  into  a  room,  in  what  sense,  if  in  any,  does 
the  room  enter  into  the  blackbeetle  .?  Go  to  Science, 
and  ask  her  these  questions ;  and  she  will  confess 
that  she  has  not  the  ghost  of  a  notion  how  to  answer 
them.  Ask  yourselves  what  you  mean  by  the  con- 
sciousness of  a  mouse  :  and  you  will  find  that  you  do 
not  know  what  you  mean.  Nor  will  men  a  thousand 
years  hence  be  any  nearer  to  that  knowledge. 

I  am  sorry :     I   began  with  an  essay,   and   here 


AN   ESSAY   FOR   STUDENTS  49 

I  am  with  a  creed.  I  believe  in  the  reality  of 
myself,  and  in  the  freedom  of  my  will :  and  I 
believe  that  we,  addressing  ourselves  to  the  universe, 
are  as  real  as  the  universe,  addressing  itself  to 
us.  But  I  cannot  even  begin  to  try  to  guess 
which  of  the  lower  animals  are  run,  as  we  are,  on 
spiritual  lines.  If  I  look  down  a  list  of  the  Verte- 
brata,  beginning  with  Man  and  ending  with  the 
Amphioxus,  I  only  see,  long  before  I  get  near  the 
Amphioxus,  the  gradual  blotting-out  and  final 
extinction  of  all  that  is  most  sure  and  most  familiar 
to  me  in  Man :  and  then  come  the  Invertebrata. 
I  believe  that  there  is  a  final  cause  of  the  lower 
animals,  wholly  independent  of  the  fact  that  they 
are  useful,  nourishing,  instructive,  or  amusing  to 
us  :  but  that  is  a  matter  of  faith,  whereas  my  belief 
in  myself  is  a  matter  of  knowledge.  Well,  I  must 
go  by  what  I  know.  Here,  not  in  blind  guesses 
and  vague  talk  about  the  lower  animals,  but  in  the 
clear  sense  that  I  am  I,  here,  in  myself,  and  in 
myself  at  my  best,  I  hope  to  find  the  Principles 
of  Psychology.  We  cannot  understand,  we  cannot 
explain,  the  anthropoid  apes.  Still,  that  is  no  reason 
why  the  anthropoid  apes  should  explain  us.  I  find 
no  logic  in  the  fashionable  phrases  about  streams 
of  states  of  consciousness  :  I  stick  to  the  old  belief, 
/  am  that  I  am^  which  is  a  comfortable  doctrine, 
and  more  than  comfortable,  for  it  does  not  outrage 
the  rules  of  logic. 


50  CONFESSIO   MEDICI 


The  faults  of  Psychology,  her  want  of  principles, 
her  neglect  of  logic,  make  her  useless  in  practical 
life.  She  thinks  that  she  is  very  useful,  or  will  be 
some  day ;  she  pretends  to  understand  us,  our 
motives,  habits,  passions,  acts,  and  imaginings  :  she 
will  interpret  us  to  ourselves.  Let  us  consider  her 
offer  to  superintend  our  conduct  and  our  work. 

What  has  she  to  do  with  our  conduct  ?  The 
influences  which  determine  conduct  are  not  in  text- 
books, but  in  the  home,  the  school,  religion,  com- 
petition, and  the  policeman  :  and  the  application  of 
Psychology  to  individual  conduct  is  like  the  applica- 
tion of  an  aseptic  dressing  to  Central  Africa.  From 
the  nursery  to  the  grave,  I  look  backward  and 
forward  :  my  father  and  mother,  brothers  and  sisters, 
friends  and  acquaintances,  masters  and  teachers  — 
how  did  Psychology  help  them  to  help  me  ?  Which 
of  us  owes  thanks  to  her  for  the  good  in  him  P 
Of  all  her  talk  about  conduct,  not  a  word  is  original, 
not  one  :  it  is  all  cribbed,  and  was  old  already,  ages 
before  her  birth,  and  was  enforced  and  accepted  in 
every  country  of  the  civilized  world.  If  we  could 
strip  her  of  her  borrowed  plumage,  she  would  be 
left  without  ethics  enough  to  make  her  decent. 

But,  hke  all  of  us  in  time  of  present  failure,  she 
promises  to  do  great  things  in  the  future,  when 
she  is  really  grown  up.     There  is  to  be  a  millennium. 


AN  ESSAY  FOR   STUDENTS  51 

The  days  will  come,  when  laws  shall  be  made  on 
psychological  principles,  and  men  and  women  shall 
be  mated,  and  children  mothered  by  the  State,  and 
evils  abolished,  and  everybody  shall  be  just  like 
everybody  else,  all  on  psychological  principles.  But 
these  days  will  not  come  till  the  principles  are  ready 
for  them,  which  now  are  conspicuous  by  their 
absence.  Meanwhile,  Edwin  and  AngeHna  will  fall 
in  love  in  the  old  style,  without  awaiting  instructions 
from  Psychology  ;  and  the  world  in  general  will  no 
more  ask  the  advice  of  Psychology  in  matters  of 
conduct  than  it  would  ask  the  gentlemen  at  Green- 
wich Observatory  to  stop  the  next  earthquake. 
Her  promises  are  magnificent :  but  what  is  the  use 
of  them  ? 

Her  proper  line  is  the  abnormal.  She  has  care- 
fully studied  exceptions  to  rules,  has  dissected  the 
twilight,  has  made  some  discoveries,  and  will  make 
more.  Psychical  Research  is  full  of  discoveries. 
I  believe  in  hypnotism,  I  believe  in  telepathy,  I 
believe  that  Psyche  may  call  to  Psyche,  and  be 
heard.  Only,  from  the  point  of  view  of  this 
essay,  I  have  three  remarks  to  make  on  Psychical 
Research. 

(i)  We  mean  by  it,  mostly,  a  patient,  critical, 
dispassionate  enquiry  into  stories  of  ghosts,  haunted 
houses,  premonitions,  thought-transference,  and  so 
forth.  But  I  would  rather,  here,  be  passionate 
than    dispassionate.     The    enquiry  touches  me  too 


52  CONFESSIO   MEDICI 

nearly  ;  Psyche  is  on  her  trial ;  it  is  a  matter  of 
her  life  or  death.  I  do  not  see  the  good  of 
researching  into  Psyche  without  believing  in  her. 
If  a  man  believes  that  she  is  a  succession  of  states 
of  consciousness,  without  anybody  there  to  be  con- 
scious that  these  states  are  successive,  his  researches 
will  be  as  vague  —  it  is  an  old  simile  —  as  a  blind 
man  looking  in  a  dark  room  for  a  black  hat  that 
is  not  in  the  room.  I  believe  that  Psyche  may 
call  to  Psyche :  but  I  do  not  believe  that  a  suc- 
cession, which  is  a  word,  not  a  thing,  can  call  to 
another  succession,  or  do  anything,  or  be  any- 
thing. I  could  as  well  imagine  two  calling  to  two, 
begging  it  to  come  and  make  four. 

(2)  Psychical  Research,  in  the  wider  sense  of 
its  name,  includes  Experimental  Psychology.  So 
far  as  I  can  understand  these  experiments,  they 
are  Physiology :  they  use  the  whole  body  as  a 
gigantic  nerve-muscle  preparation.  That  is  not 
Psychology,  but  Physiology :  it  is  the  method 
which  you  follow  in  a  case  of  paralysis.  Say 
that  you  suspect  some  loss  of  power  in  one  arm ; 
Squeeze  my  finger,  you  say  to  the  patient ;  you 
test  his  muscles,  reflexes,  appreciations  of  touch 
and  of  warmth,  and  so  forth.  But  that  is  not 
Psychology.  Neither  is  it  Psychology,  to  study 
how  long  it  takes  a  man  to  spot  a  word  flashed 
before  his  eyes,  or  to  respond  to  a  signal  :  it  is 
merely  a  parlour-game  of  Physiology. 


AN   ESSAY  FOR   STUDENTS  53 

(3)  Abnormal  people,  spiritual  freaks,  are  what 
Psychology  loves.  It  does  not  appear  that  she 
does  much  for  them,  but  she  demonstrates  them, 
plays  tunes  on  them.  One  is  clairvoyante,  another 
has  fits,  another  has  two  personalities,  and  I  have 
read  of  a  distressed  lady  who  had  five  ;  another 
is  a  daemoniac  Frenchwoman,  Madame  A  or  Mile. 
X,  a  most  untrustworthy  person.  Psychology  plays 
with  these  unhappy  people,  as  a  bad  child  pulls  the 
wings  off  a  fly,  to  see  what  it  will  do  without  them. 
Of  course,  these  cases  are,  more  or  less,  real :  but 
they  are  so  rare,  that  we  learn  from  them  next  to 
nothing. 

But  what  use  is  she  to  us  in  practice  ?  Take, 
for  example,  cases  of  drink,  and  cases  of  insanity. 
We  class  them  as  organic  diseases  of  the  brain,  and 
so  they  are :  and  we  look  for  help,  in  their  treat- 
ment, to  the  medical  sciences.  But  we  never  look 
to  Psychology  :  except  that  hypnotism  is  a  method 
of  treatment.  And  hypnotism,  surely,  is  what  we 
must  call  a  spiritual  treatment;  it  falls  in  with  the 
commonplace  influences  of  one  will  over  another, 
which  are  spiritual  influences.  Therein  the  patient 
must  minister  to  himself.  Sixpennorth  of  drugs  to 
get  at  his  brain,  and  six  months  of  spiritual  treat- 
ment to  get  at  him  :  that  is  the  way  of  practice. 
I  do  not  say  that  the  spiritual  treatment  is  our 
business:  it  is  the  business  of  the  patient's  friends. 
But  I   do  say  that  the  record  of  the  dealings  of 


54  CONFESSIO   MEDICI 

Psychology  with  Psyche  in  trouble  is  a  record  of 
words,  not  of  deeds.  To  hear  her  talking  of  these 
diseases,  is  to  be  reminded  of  Nero  fiddling  while 
Rome  was  burning. 

I  seem  to  have  come  to  this  lame  conclusion, 
that  our  chief  use  of  Psychology  is  to  satisfy  the 
examiners  in  Psychology.  Also,  she  makes  us  think. 
But,  when  she  says  that  we  are  streams  of  states 
of  consciousness,  then  she  is  talking  nonsense, 
not    Science. 


A   GOOD    EXAMPLE 

It  seems  a  pity,  that  the  good  example  of  Ambroise 
Pare  is  almost  forgotten.  He  was  born  in  1510, 
of  working  people,  in  a  village :  he  went  early  into 
apprenticeship,  and  thus  escaped  the  deadening 
influences  of  the  University  of  Paris  —  /  make  no 
claim  to  have  read  Galen  either  in  Greek  or  in  Latin : 
for  it  did  not  please  God  to  he  so  gracious  to  my  youth 
that  it  should  he  instructed  either  in  the  one  tongue 
or  in  the  other.  For  three  years,  or  it  may  be  four, 
he  held  a  resident  appointment  at  the  Hotel  Dieu. 
For  more  than  twenty  years,  off  and  on,  he  was 
an  Army-surgeon,  with  a  foothold  in  Paris.  He 
had  a  great  practice,  wrote,  lectured,  upheld  the 
rights  of  the  surgeons  against  the  physicians,  held 
many  Court  appointments,  and  was  twice  married. 
He  attended  Henri  II.,  Fran9ois  II.,  Charles  IX., 
Henri  III.,  Fran9ois  due  de  Guise,  and  Coligny  ; 
knew  Vesalius,  Catherine  de  Medicis,  Mary  Stuart, 
and  all  Paris  ;  was  on  the  side  of  the  Huguenots : 
and  outlived,  at  eighty,  the  siege  of  Paris  by 
Henri  IV. 

55 


56  CONFESSIO   MEDICI 

From  Malgaigne  and  le  Paulmier,  we  may  learn 
all  about  his  life.  In  his  books,  we  possess  him, 
his  affairs,  habits,  and  opinions ;  and  may  almost 
recognize  his  very  air,  and  the  sound  of  his  voice. 
The  record  of  his  adventures  with  the  Army,  his 
Voyages  faicts  en  divers  Lieulx^  is  fine  reading. 
Here  is  one  who  can  praise  without  offence  his 
own  performances,  and  chronicle  with  proper  pride 
his  own  words,  and  score  off  a  fool,  and  relish  his 
meat  and  drink :  a  shrewd,  happy,  confident, 
business-like  gentleman,  not  wholly  free,  in  a  vain 
and  cruel  age,  from  vanity,  nor  incapable  of  cruelty, 
but  steadily  compassionate,  humble,  wise,  and 
honourable :  and  a  true  lover  of  his  country,  his 
home,  and  his  profession.  Everybody  reads  Boswell 
and  Pepys,  but  who  reads  Pare  ?  All  his  gossip 
about  his  patients,  and  all  his  good  stories  of  the 
campaigns,  the  months  of  endurance,  the  moments 
of  terror,  the  dreadful  jobs  to  be  done  after  an 
engagement,  the  brutality  of  the  Spanish  soldiers, 
the  rough-and-tumble  ways  of  the  French  camp, 
all  the  tragedy  and  all  the  comedy,  are  shelved  in 
this  or  that  library,  and  the  dust  is  thick  on 
Opera  Omnia.  We  have  no  time  to  read  of  the 
life  of  an  Army  that  is  three  centuries  dead  ;  we 
know  only  this  of  Pare,  that  he  used  to  say,  / 
dressed  him,  and  God  cured  him  :  and  he  deserves 
more  recognition  than  the  memory  of  that  one 
phrase. 


A  GOOD   EXAMPLE 


57 


Je  le  pans  ay  et  Dieu  le  guarit:  and  he  rings  changes 
on  it,  thus : 

I  dressed  him,  and  God  cured  him. 

My  lord,  by  the  grace  of  God,  was  cured. 

I  did  him  the  services  of  physician,  surgeon,  apothecary, 
and  cook.  I  dressed  him,  to  the  end  of  the  case,  and  God 
cured  him. 

I  returned  to  Paris,  with  my  gentleman  whose  leg  I  had 
cut  off:  I  dressed  him,  and  God  cured  him.  I  sent  him 
home  happy  with  a  wooden  leg,  and  he  was  well  satisfied, 
saying  that  he  had  got  off  cheap. 

I  reduced  and  dressed  his  leg  so  skilfully  that  he  was  free 
from  pain,  and  slept  all  night  :  and  in  time,  thank  God,  he  was 
cured,  and  is  now  in  the  King's  service. 

God  blessed  my  work  so  well,  that  I  sent  my  patients 
back  to  Paris  ;  where  I  still  had  to  make  some  incisions  in 
M.  de  Mansfeld's  arm.  He  was  cured,  by  the  grace  of  God, 
and  made  me  a  handsome  present  ;  so  I  was  well  content 
with  him,   and  he  with  me:  as  he  has  shown  me  since. 

Always,  this  piety  was  in  him :  not  only  in 
practice,  but  in  daily  life.  It  is  true  that  every- 
body, in  his  time,  talked  religion  ;  but  the  sincerity 
of  Fare's  talk  is  as  clear  as  crystal.  And  it  is  true 
that  he  was  superstitious  ;  but  he  was  less  supersti- 
tious than  many  of  his  grand  patients,  and  mocked 
at  the  fashionable  craze  for  amulets  and  horoscopes. 
What  nickname,  I  wonder,  had  he  at  the  Court  ? 
What  did  the  Queen  Mother,  and  the  mad  Valois 
line,  make  of  him  ?  Observe  him,  this  uneducated 
self-made  man,  standing  up,  at  that  Court,  for 
plain  living  and  Huguenot  thinking :  and  the  King 


58  CONFESSIO   MEDICI 

himself,  on  the  night  of  the  Massacre,  locking  him 
in  a  room  of  the  Louvre,  swearing  that  it  was  not 
reasonable  that  a  man,  who  was  worth  a  whole  world 
of  men,  should  be  murdered. 

But  consider  his  works.  Sitting  here,  transcribing 
Opera  Omnia,  I  could  fill  a  book  with  his  good 
stories  and  his  good  cases  :  but  one  must  suffice, 
and  he  who  wants  more  can  find  them  for  himself. 

M.  le  Marquis  d'Auret,  brother  of  M.  le  Due 
d' Ascot,  was  a  very  magnificent  young  gentleman, 
twenty  years  old.  He  was  suffering  from  a  gun- 
shot wound  of  the  thigh,  which  had  fractured  the 
bone.  For  seven  months  he  had  been  lying  in 
misery,  at  Mons  in  Hainault,  slowly  nearing  death, 
and  attended  by  many  doctors.  The  King,  at  the 
Duke's  request,  sent  Pare,  who  was  at  this  time 
sixty  years  old,  and  premier  surgeon  at  the  Court. 
Pare  found  the  young  man  in  a  frightful  state  ;  as 
if  he  had  been,  for  seven  months,  with  a  compound 
fracture  of  the  femur,  and  diffuse  suppuration,  under 
the  Christian  Science  treatment : 

Seeing  and  considering  all  these  great  complications,  and 
the  vital  powers  thus  broken  down,  truly  I  was  very  sorry  I 
had  come  to  him,  because  it  seemed  to  me  that  there  was 
little  hope  that  he  would  escape  death.  All  the  same,  to 
give  him  courage  and  good  hope,  I  told  him  I  would  soon 
set  him  on  his  legs,  by  the  grace  of  God,  and  the  help  of 
his  physicians  and  surgeons. 

Having  seen  him,  I  went  a  walk  in  a  garden,  and  prayed 
God    to    show    me   this   grace,    that   he    should   recover,   and    to 


A  GOOD   EXAMPLE  59 

bless  our  hands  and  our  medicaments  to  cure  such  a  complica- 
tion of  diseases.  I  turned  in  my  mind  what  measures  I  must 
take  to  this  end.  They  called  me  to  dinner.  I  came  into 
the  kitchen,  and  there  I  saw,  taken  out  of  a  great  pot,  half 
a  sheep,  a  quarter  of  veal,  three  great  pieces  of  beef,  two 
fowls,  and  a  very  large  piece  of  bacon,  with  abundance  of 
good  herbs.  Then  I  said  to  myself  that  the  broth  of  the 
pot  would  be  full  of  juices,   and  very  nourishing. 

After  dinner,  we  began  our  consultation,  all  the  physicians 
and  surgeons  together,  in  the  presence  of  M.  le  Due  d' Ascot 
and  some  gentlemen  who  were  with  him.  I  began  to  say 
to  the  surgeons  that  I  was  astonished  that  they  had  not  made 
incisions  in  the  patient's  thigh,  seeing  that  it  was  all  suppu- 
rating, and  the  thick  matter  in  it  very  fetid  and  offensive, 
showing  that  it  had  long  been  pent-up  there ;  and  I  had 
found  with  the  probe  caries  of  the  bone,  and  scales  of  bone 
already  loose.  They  answered  me.  Never  would  he  consent 
to  it :  indeed,  that  it  was  near  two  months,  since  they  had 
been  able  to  get  leave  to  put  clean  sheets  on  the  bed,  and 
that  one  scarce  dared  touch  the  coverlet,  so  great  was  his 
pain.  Then  I  said.  To  cure  him,  we  must  touch  something 
else  than  the  coverlet  of  his  bed.  Each  said  what  he  thought 
of  the  malady  of  the  patient,  and,  in  conclusion,  they  all  held 
it  hopeless.  I  told  them  that  there  was  still  some  hope, 
because  he  was  young,  and  God  and  Nature  sometimes  do 
what  seems  to  physicians  and  surgeons  impossible. 

Then  follows  a  discourse,  of  prodigious  length. 
The  treatment,  he  tells  the  doctors,  must  include 
free  incisions,  fomentations,  a  clean  bed,  hot  bricks 
and  a  hot  bottle  duly  medicated,  massage,  a  dusting 
powder,  a  plaster  and  a  pillow  for  a  bed-sore,  a 
refrigerant  over  the  heart,  a  head-cloth  and  a  fore- 
head cloth  and   a  pomander,  an  opiate  at  night,  a 


6o  CONFESSIO   MEDICI 

generous  diet,  a  moderate  allowance  of  wine  :  "  and, 
(he  adds)  we  must  make  artificial  rain,  pouring  water 
from  some  high  place  into  a  cauldron,  that  he  may- 
hear  the  sound  of  it,  whereby  sleep  shall  be  induced 
on  him."  For  the  fomentations,  a  decoction  of 
sage,  rosemary,  thyme,  lavender,  chamomile,  melilot, 
and  red  roses  boiled  in  white  wine :  for  a  generous 
diet,  raw  eggs,  plums  stewed  in  wine  and  sugar, 
the  broth  of  the  great  pot,  white  meat  of  fowls, 
partridge-wings,  and  other  roast  meats  easy  to 
digest,  with  orange,  verjuice,  sorrel,  and  bitter 
pomegranates :  or  boiled  with  good  herbs,  such 
as  lettuce,  parsley,  chicory,  bugloss,  marigold, 
and  the  like.  This  excellent  food,  and  the  well- 
flavoured  opiate,  and  the  fragrant  blend  of  roses, 
liHes,  poppies,  and  camphor  on  the  forehead-cloth, 
and  the  good  bread,  which  must  be  farm-house 
bread  neither  too  stale  nor  too  new,  are  all  noted 
with  the  utmost  minuteness.  Yet  the  discourse 
is  mainly  on  pathology.  If  he  spoke  it  as  he 
published  it,  the  greater  part  of  the  afternoon  must 
have  been  occupied. 

This  my  .>  discourse  was  well  approved  by  the  physicians 
and  surgeons.  The  consultation  ended,  we  went  back  to  the 
patient,  and  I  made  three  openings  in  his  thigh.  .  .  .  Two 
or  three  hours  later,  I  got  a  bed  made  near  his  old  one, 
with  clean  white  sheets  on  it  ;  then  a  strong  man  put  him 
into  it,  and  he  was  thankful  to  be  taken  out  of  his  foul, 
stinking  bed.  Soon  afterward,  he  asked  to  sleep ;  which  he 
did  for  nearly  four  hoars  ;  and  everybody  in  the  house 
began  to  feel  happy,   and  especially  his  brother. 


A  GOOD   EXAMPLE  6i 

Slowly,  the  young  man  recovered  ;  and  we  have 
a  pleasant  picture  of  his  convalescence  : 

I  stopped  there  about  two  months,  not  without  seeing 
many  patients,  rich  and  poor,  who  came  to  me  from  three 
or  four  leagues  round.  He  gave  food  and  drink  to  the 
needy,  and  commended  them  all  to  me,  asking  me  to  help 
them  for  his  sake.  I  protest  that  I  reflised  not  one,  and 
did  for  them  all  that  I  could,  to  his  great  pleasure.  Then, 
when  I  saw  him  beginning  to  get  well,  I  told  him  that  he 
must  have  viols  and  violins,  and  a  buffoon  to  make  him  laugh  : 
which  he  did.  In  a  month,  we  got  him  into  a  chair ;  and 
he  had  himself  carried  about  his  garden,  and  to  the  door  of 
his  chateau,  to  watch  people  passing.  The  villagers,  for  two 
or  three  leagues  round,  now  that  they  could  see  him,  came 
on  holidays  to  sing  and  dance,  a  regular  crowd  of  light- 
hearted  country  folk,  rejoicing  in  his  convalescence,  all  glad 
to  see  him,  not  without  plenty  of  laughter  and  plenty  of 
drink.  He  always  gave  them  a  hogshead  of  beer  :  and  they 
all  drank  his  health  with  a  will.  He  was  dearly  loved,  both 
by  the  nobility  and  by  the  common  people,  as  for  his  generosity, 
so  for  his  handsome  face  and  his  courtesy,  with  a  kind  look 
and  a  gracious  word  for  everybody.  In  six  weeks  he  began 
to  stand  a  little  on  crutches,  and  to  put  on  flesh  and  get  a 
good  natural  colour.  He  wanted  to  go  to  Beaumont,  his 
brother's  place  :  and  was  taken  thither  in  a  carrying-chair, 
by  eight  men  at  a  time.  And  the  peasants,  in  the  villages 
through  which  we  passed,  when  they  knew  it  was  M.  le  Marquis, 
fought  who  should  carry  him,  and  insisted  that  we  should  drink 
with  them  :  and  it  was  only  beer,  but  they  would  have  given 
us  hippocras,  if  there  had  been  any.  And  all  were  glad  to 
see  him,    and  prayed   God   for   him. 

There  is  no  room  here  to  describe  the  life  at 
Beaumont,    the    feasting,    the    fencing-matches,  the 


62  CONFESSIO   MEDICI 

fifty  guests  met  to  amuse  the  patient ;  and  how 
they  tried,  more  shame  to  them,  by  all  drinking 
to  Pare,  to  make  him  drunk,  and  failed,  for  he 
would  drink  no  more  than  his  usual  allowance ; 
and  how,  at  last,  well-thanked,  well-paid,  he  got 
away  home.  We  do  not  now  record  cases  in 
this   lively   style : 

I  took  my  leave  of  the  Duchess,  who  drew  a  diamond  from 
her  finger,  and  gave  it  to  me,  in  her  gratitude  for  my  good 
care  of  her  brother-in-law  :  and  the  diamond  was  worth 
fifty  crowns.  I  was  two  days  and  a  half,  on  my  way  home, 
seeing  the  city  of  Antwerp  ;  where  certain  merchants  begged 
that  they  might  have  the  honour  of  giving  us  a  dinner  or 
a  supper  :  it  was.  Who  should  have  us  ?  And  they  were  all 
truly  glad  to  hear  how  M.  d'Auret  was  doing,  and  made 
more  of  me  than  I  asked.  I  forgot  to  say  that  the  Spaniards 
have  since  ruined  and  demolished  his  Chateau  d'Auret,  and 
have  sacked,  plundered,  and  burned  all  the  houses  and  villages 
belonging  to  him,  because  he  would  not  be  of  their  wicked 
party  in  their  assassination  and  ruin  of  the  Netherlands. 

Observe,  all  you  who  are  students,  that  the 
patient  had  six  doctors,  but  no  nurse,  and  that 
Pare  understood  the  whole  art  of  nursing  ;  and  so 
ought  you.  Even  Charles  IX.,  dying  of  phthisis, 
and  haunted  by  the  ghosts  of  the  Massacre,  had  no 
nurse,  save  the  old  lady  who  had  looked  after  him 
when  he  was  a  child :  and  she,  as  we  happen  to 
know,  composed  herself  to  sleep  while  he  was  dying. 
Observe,  also,  the  sequence  of  Pare's  thoughts : 
the  shock  of  the  first  sight  of  the  case,  the  bold 


A  GOOD   EXAMPLE  63 

encouragement  of  the  patient,  the  meditation  in  the 
open  air,  the  shrewd  glance  at  the  great  pot,  the 
authority  in  consultation,  the  readiness  to  operate. 
Observe,  especially,  his  glorious  common-sense  and 
his  scrupulous  attention  to  every  detail  of  the 
treatment. 

For  his  home-life,  see  le  Paulmier.  The  start  in 
practice  in  Paris,  with  two  little  rooms  on  a  ground- 
floor,  handy  to  the  fashionable  duelling-field  :  the 
poverty  of  his  first  marriage,  the  coming  of  pro- 
sperity, the  move  into  a  good  house,  the  purchase 
of  adjoining  houses,  and  of  a  cottage  at  Meudon  : 
the  affluent  air  of  his  second  marriage,  and  what 
important  personages  were  sponsors  for  the  grand- 
children, and  how  the  recurrent  names  of  old  friends, 
as  witnesses,  enliven  marriage-settlements  and  leases  : 
and  what  family  affection  was  in  the  home,  and  how 
the  little  church  round  the  corner.  Saint  Andre  des 
Arcs,  baptized,  married,  and  buried  them  all  —  you 
find  it  all  made  out  and  put  in  order.  The  evidence 
is  complete,  that  Pare  was  happy  in  his  family  and 
in  his  friends,  a  good  business  man,  charitable, 
kindly,  a  bit  vain,  a  bit  old-fashioned,  fond  of  life, 
glad  to  be  a  loyal,  hard-working,  and  well-beloved 
citizen.  If  now,  at  the  corner  of  the  Rue  de 
I'Hirondelle,  close  to  the  Quai  des  Augustins,  you 
could  come  across  the  jocund  ghost  of  the  Maison 
des  Trois  Maures,  its  windows  would  be  radiant 
with  light,  and  you  would  hear  laughter  and  friendly 


64  CONFESSIO   MEDICI 

voices,  and  would  smell  a  good  dinner,  if  dinners 
have  ghosts :  but  you  would  hear  no  solemn  or 
pedantic  talk,  no  Greek  and  Latin.  This  ghostly 
house,  when  it  was  alive,  was  the  home  of  a  man 
self-made  and  self-taught,  who  won  his  everlasting 
name,  without  help  of  birth,  education,  privilege, 
or  money,  by  hard  work,  by  wholesome  self- 
assurance,  by  spiritual  goodness,  and  by  strict 
attention  to  business. 

We  have  difficulties  which  did  not  come  to 
him.  Incessant  examinations,  books,  and  schedules 
weigh  on  our  Hospital  life :  then  comes  practice, 
and  the  stress  of  competition,  so  severe  that  many 
of  us  fail,  or  partly  fail,  do  what  we  will.  To 
him,  we  think,  success  was  easier.  He  just  was 
apprentice.  House-surgeon,  barber-surgeon.  Army- 
surgeon,  and  eminent  surgeon,  each  in  due  time : 
he  had  elbow-room,  he  was  free,  he  was  lucky. 

It  is  true  that  Pare,  at  the  very  beginning 
of  his  time  in  the  Army,  even  before  he  was 
quahfied,  had  a  grand  bit  of  luck.  His  famous 
discovery,  that  boiling  oil  is  not  good  for  gunshot 
wounds,  was  ascribed,  even  by  him,  to  chance.  It 
happened  at  Suse,  a  little  place  near  Mont  Cenis, 
in  1537: 

The  enemy  within  the  castle,  seeing  our  men  come  on 
them  with  great  fiiry,  did  all  that  they  could  to  defend 
themselves,  and  killed  and  wounded  many  of  our  soldiers  with 
pikes,    arquebuses,    and    stones  :    whereby    the    surgeons    had    all 


A  GOOD  EXAMPLE  65 

their  work  cut  out  for  them.  Now  I  was  at  this  time  a 
fresh-water  soldier  ;  I  had  not  yet  seen  gunshot  wounds  at 
the  first  dressing.  1  had  read  in  John  de  Vigo,  book  one.  Of 
Wounds  ifi  Generaly  chapter  eight,  that  wounds  made  by  fire- 
arms partake  of  venenosity,  by  reason  of  the  gunpowder  ;  and 
for  their  cure  he  bids  you  cauterize  them  with  oil  of  elders, 
scalding  hot,  mixed  with  a  little  treacle.  And  to  make  no 
mistake,  before  I  would  use  the  said  oil,  knowing  that  it  was 
to  bring  great  pain  to  the  patient,  I  asked  first,  before  I 
applied  it,  what  the  other  surgeons  used  for  a  first  dressing ; 
which  was,  to  put  the  said  oil,  boiling  well,  into  the  wounds, 
with  tents  and  setons  :  wherefore  I  took  courage  to  do  as 
they  did.  At  last,  my  oil  ran  short  ;  and  I  was  compelled, 
instead  of  it,  to  apply  a  digestive  made  of  yolks  of  eggs,  oil 
of  roses,  and  turpentine.  In  the  night,  I  could  not  sleep  in 
quiet,  fearing  some  default  in  the  not  cauterizing,  lest  I  should 
find  those,  to  whom  I  had  not  applied  the  said  oil,  dead  from 
the  poison  of  their  wounds ;  which  made  me  rise  very  early 
to  visit  them  :  where,  beyond  my  expectation,  I  found  that 
they  to  whom  I  had  applied  my  digestive  had  suffered  but 
little  pain,  and  their  wounds  without  inflammation  or  swelling, 
having  rested  fairly  well  that  night.  The  others,  to  whom  the 
boiling  oil  was  applied,  I  found  feverish,  with  great  pain,  and 
swelling  round  the  edges  of  their  wounds.  Then  I  resolved 
nevermore  to  burn  thus  cruelly  poor  men  with  gunshot  wounds. 
When  I  was  at  Turin,  I  found  a  surgeon  famed  above  all 
the  rest  for  his  treatment  of  gunshot  wounds ;  into  whose 
favour  I  found  a  way  to  insinuate  myself,  that  I  might  have 
the  recipe  of  his  balm,  as  he  called  it,  wherewith  he  dressed 
these  wounds.  And  he  made  me  pay  my  court  to  him  for 
two  years,  before  I  could  possibly  get  the  recipe  out  of  him. 
In  the  end,  thanks  to  my  gifts  and  presents,  he  gave  it  to 
me,  which  was  this,  to  boil  down,  in  oil  of  lilies,  young 
whelps   just    born,    and    earthworms    prepared    with    Venice    tur- 


66  CONFESSIO   MEDICI 

pentine.  Then  was  I  joyful,  and  my  heart  made  glad,  that 
I  had  learned  his  remedy,  which  was  like  that  which  1  had 
obtained  by  chance. 

See  how  I  learned  to  treat  gunshot  wounds  :  not  out  of  books. 

His  other  great  discovery,  the  use  of  the  ligature, 
instead  of  the  red-hot  irons,  to  stop  the  bleeding 
of  an  amputation,  was  made  about  1552:  which 
it  pleased  God  to  teach  me^  without  I  had  ever  seen 
it  done  in  any  case^  no,  nor  read  of  it.  Prometheus, 
who  brought  fire  to  suffering  mortals,  is  not  to  be 
compared  with  this  good  surgeon,  who  took  it  away 
from  them. 

Once  we  begin  to  count  his  gifts,  it  is  a  long 
list.  He  had  a  keen,  orderly,  business-like  mind, 
intensely  practical ;  a  pleasant  cleanness  of  talk  on 
sexual  subjects  ;  perfect  contentment  with  his  place 
in  society ;  love  of  home,  pride  in  his  work,  be- 
lief in  himself,  and  unaffected  sympathy  with  his 
patients.  These  gifts,  and  more,  were  in  him,  and 
kept  him  young. 

But  all  praise  of  him  is  poor  stuff,  beside  that 
one  picture  of  him  which  is  in  the  Memoirs  of 
Pierre  de  I'Estoile.  In  1590,  after  the  battle  of 
Ivry,  came  the  siege  of  Paris.  It  began  in  May ; 
by  the  end  of  August,  the  poor  were  dying  like 
flies,  and  the  dead  were  lying  in  the  streets  :  the 
agony  of  that  siege,  and  the  fury  of  the  League, 
under  the  iron  rule  of  the  Archbishop  of  Lyon, 
belong    to    history.      Fare,    eighty   years   old,    andi 


A  GOOD   EXAMPLE  67 

with  only  four  months  to  live,  was  still  afoot  in 
the  hot  streets,  among  the  starving  crowd.  His 
practice,  we  may  be  sure,  had  left  him,  and  gone 
to  Antoine  Portail  and  other  surgeons.  His 
grand  patients,  Catherine  de  Medicis,  the  King, 
the  Guises,  were  dead.  Suddenly,  close  to  his 
own  house,  he  came  face  to  face  with  the  Arch- 
bishop of  Lyon :  either  by  chance,  or  of  set 
purpose  to  speak  his  mind  to  him.  "  I  remem- 
ber," says  Pierre  de  I'Estoile,  "about  eight  or  ten 
days,  at  most,  before  the  siege  was  raised,  Mon- 
seigneur  the  Archbishop,  crossing  over  the  end  of 
the  Pont  Saint  Michel,  when  he  found  his  way 
blocked  by  a  crowd  of  those  who  were  dying  of 
hunger,  they  cried  out  to  him,  begging  for  bread 
or  for  death :  he  not  knowing  what  to  say  to 
them.  Master  Ambroise  Pare  meets  him,  and  says 
to  him  in  a  loud  voice,  '  Monseigneur,  this  poor 
people,  whom  you  see  here  round  you,  are  dying 
of  the  cruel  pains  of  famine,  and  they  ask  pity  of 
you.  For  God's  sake.  Monsieur,  have  pity  on 
them,  if  you  want  God  to  have  pity  on  you : 
think  a  little  of  the  high  place  to  which  God  has 
called  you,  and  how  the  cry  of  these  poor  men 
and  women  goes  up  to  Heaven,  and  is  a  warning 
sent  you  by  God,  to  remind  you  of  the  duties  of 
your  office,  for  which  you  have  to  answer  to  Him. 
Therefore,  by  that  office,  and  by  the  power  which 
we  all  know  that  you  have,  bring  about  peace  for 


68  CONFESSIO   MEDICI 

us,  and  give  us  a  way  of  living:  for  the  poor  can 
no  longer  help  themselves.  Do  you  not  see  that 
all  Paris  is  dying,  thanks  to  the  wicked  men  who 
wish  to  prevent  peace,  which  is  the  special  work 
of  God  ?  Set  all  your  strength  against  them. 
Monsieur :  take  in  hand  the  cause  of  this  poor 
afflicted  people,  and  God  will  bless  you  and  repay 
you/  Monseigneur  the  Archbishop  said  nothing, 
or  next  to  nothing :  only,  he  was  patient  to  hear 
him  to  the  end  and  not  interrupt  him,  which 
was  not  his  usual  way.  And,  afterward,  he  said 
that  the  good  man  had  fairly  astonished  him ; 
and  again,  that  this  was  not  the  sort  of  politics 
he  was  used  to  hear  talked ;  and  that  Master 
Ambroise  Pare  had  waked  him  up,  and  made 
him  think  of  many  things."  Four  months  later, 
Pierre  de  I'Estoile  writes :  "  On  Thursday,  De- 
cember the  twentieth,  the  Eve  of  Saint  Thomas, 
at  Paris,  in  his  own  house,  died  Master  Ambroise 
Pare,  the  King's  surgeon,  eighty  years  old ;  a 
learned  man,  and  the  chief  of  all  surgeons  ;  who, 
even  against  the  times,  all  his  life  talked  and 
spoke  openly  for  peace  and  for  the  people :  which 
made  him  as  much  beloved  by  the  good  as  he 
was  opposed  and  hated  by  the  wicked." 


PRACTICE 

The  casket  scenes  in  the  Merchant  of  Venice  are 
exquisite  poetry  wasted  on  an  episode  so  fooHsh 
that  I  wonder  nobody  has  taken  it  for  a  musical 
comedy :  and  in  my  imagination  I  see  the  posters 
of  that  new  piece,  and  read,  on  the  mind's 
hoardings,  its  ugly  name. 

The  challenge  of  the  caskets  was  devised  by 
Portia's  father,  on  his  death-bed,  under  divine 
inspiration.  She  knows,  but  must  not  say,  which 
of  them  contains  her  portrait.  I  wish  that  she 
did  not  know :  I  should  like  to  watch  the 
perplexity  of  her  suitors  mirrored  in  her  face. 
Each  suitor  was  challenged  on  the  very  threshold 
of  courtship ;  and  a  strange  and  most  unreasonable 
oath  was  exacted  from  him  : 

Arragon.    I  am  enjoined  by  oath  to  observe  three  things. 
First,  never  to  unfold  to  any  one. 
Which  casket  'twas  I  chose  :   next,  if  I  fail 
Of  the  right  casket,  never  in  my  life 
To  woo  a  maid  in  way  of  marriage  :  lastly. 
If  I  do  fail  in  fortune  of  my  choice. 
Immediately  to  leave  you  and  be  gone. 
69 


70  CONFESSIO   MEDICI 

So  it  is,  with  us  doctors,  as  with  Portia's  suitors. 
Practice,  when  we  come  courting  her,  challenges 
us.  She  could  tell  us,  if  she  would,  which  casket 
to  choose ;  but  she  will  not.  Even  when  Bassanio 
comes,  she  will  not  tell  him  :  is  it  likely  that  she 
would  tell  us,  who  thrust  ourselves,  unasked  and 
unwelcome,  into  her  house  ?  Belmont  is  full  of 
us,  and  she  is  tired  of  us  all. 

It  is  true  that  we,  if  we  fail,  are  free  to  tell  other 
suitors  how  we  chose,  and  so  we  do :  but  they  will 
not  believe  us.  It  is  true,  also,  that  we  are  free  to 
follow  another  love,  if  we  fail  to  find  Practice  :  but 
every  profession,  nowadays,  challenges  its  suitors. 

Consider,  Gentlemen  —  thus  I  shall  begin  my 
next  Address  to  Students  at  the  Opening  of  the 
Winter  Session  —  how  it  was  that  the  Prince  of 
Morocco  and  the  Prince  of  Arragon  failed,  and 
Bassanio  succeeded,  in  the  locaHzation  of  fair 
Portia's  counterfeit :  and  let  me  recall  to  you  the 
inscriptions  on  the  caskets  : 

Gold. 
Who  chooseth  mCy  shall  gain  what  many  men  desire. 

Silver. 
Who  chooseth  me^  shall  get  as  much  as  he  deserves. 

Lead. 
Who  chooseth  me,  must  give  and  hazard  all  he  hath. 

Morocco,  one  of  the  greatest  of  Shakspeare's 
lesser  characters,  is,  of  course,  Othello's  understudy. 
He  has  Othello's  dignity,  authority,  and  faith.     He 


PRACTICE  71 

brings  the  air  of  the  desert  along  with  him  :  it 
hardly  crosses  his  mind  that  he  is  in  Italy,  among 
a  people  fond  of  thimble-rigging  tricks.  In  all 
the  world,  this  exalted  spirit  sees  only  Portia  and 
himself  But  he  cannot  keep  himself  out  of  the  line 
of  his  own  vision.  That  is  why  he,  alone  of  the 
three  suitors,  takes  the  trouble  to  read  the  caskets 
twice  :  not  only  from  fear  of  losing  Portia,  but 
from  fear  of  committing  himself  That,  also,  is 
why  he  rejects  the  leaden  casket :  not  only  because 
it  is  unworthy  of  her,  but  because  it  is  unworthy 
of  him,  whose  golden  mind  stoops  not  to  shows  of 
dross.  Over  the  silver  casket,  he  stays  long,  still 
contemplating  himself,  weighing  his  value  with  an 
even  hand,  and  allowing  it  full  weight : 

As  much  as  I  deserve  ?     Why,  that's  the  lady: 
I  do  in  birth  deserve  her,  and  in  fortunes. 
In  graces,  and  in  qualities  of  breeding; 
But,  more  than  these,  in  love  I  do  deserve. 
What  if  I  strayed  no  further,  but  chose  here  ? 

But  he  reads  again  the  saying  graved  in  gold ; 
and  then  and  there  he  forgets  at  last  himself,  and 
out  of  him  with  a  rush  comes  a  love-song  of  such 
fire  as  would  never  do  for  a  musical  comedy,  and 
he  calls  in  a  fury  of  impatience  for  the  key,  and 
open  flies  the  casket,  and  Oh  Hell^  What  have  we 
here  ?  a  skull,  with  a  scroll  poked  into  one  of  its 
orbits.  The  moral,  for  us  doctors,  is  twofold. 
First,  that  birth  and  fortune,  graces,  and  qualities 


72  CONFESSIO   MEDICI 

of  breeding,  do  not  ensure  Practice.  Next,  that 
the  imaginative  man  is  apt  to  idealize  Practice,  and 
to  be  in  love  with  his  own  vision  of  her  descending 
out  of  Heaven.  His  golden  mind  sets  up  a 
golden  image,  and  worships  it,  and  will  not  stoop 
to  shows  of  dross.  But  Practice,  though  she  is 
of  heavenly  origin,  is  a  human  business,  competitive, 
and  overcrowded  ;  which  Heaven  is  not. 

Arragon,  compared  with  Morocco,  is  a  poor 
creature,  with  no  care  for  anybody  but  himself. 
He  hardly  notices  the  leaden  casket,  simply  fails 
to  see  why  it  is  there ;  and  he  refuses  the  gold 
for  this  foolish  reason,  that  most  people,  being 
commonplace,  would  choose  it,  and  he  is  sure 
that  he  is  not  commonplace.  No,  what  he  deserves 
is  good  enough  for  him,  for  whom  nothing  is  too 
good.  Therewith  he  opens  the  silver  casket,  and 
loses  alike  Portia  and  his  temper :  for  he  finds 
in  it  a  sort  of  comic  valentine,  the  portrait  of  a 
blinking  idiot,  with  a  rude  set  of  verses.  I  have 
profound  sympathy  with  Arragon.  First,  because 
Portia  despises  and  mocks  him.  Next,  because,  at 
this  or  that  theatre,  he  is  not  acted  at  all,  but 
simply  omitted :  that  is  what  they  call  the  acting 
version  of  the  play.  Finally,  and  especially,  because 
I  approve  his  choice.  I  deplore  its  motive  ;  none 
the  less,  I  admire  its  principle. 

Bassanio,  after  a  beautiful  soliloquy  on  the 
deceitfulness    of  appearances,  goes  straight  for  the 


PRACTICE  73 

right  casket.  Oh,  I  have  no  patience  with  him. 
Shakspeare  made  him,  therefore  let  him  pass 
for  a  man :  but  look  at  him.  Bassanio,  to  be 
moralizing  over  the  deceitfulness  of  appearances, 
who  has  just  borrowed  three  thousand  ducats  for 
clothes  and  finery,  to  outshine  Morocco  and 
Arragon.  It  is  for  Portia's  money  —  how  to  get 
clear  of  all  the  debts  I  owe — that  he  goes  to  Bel- 
mont. He  is  so  vain,  that  he  tells  of  her  evident 
admiration  of  him  ;  so  careful  of  appearances,  that 
he  warns  Gratiano  not  to  disgrace  him  by  being 
vulgar  when  they  get  there :  and  it  was  a  most 
necessary  warning.  Let  us  be  glad,  that  Bassanio 
never  really  happened.  All  the  same,  he  is  the 
successful  suitor  :  and  the  moral  is,  that  Practice 
admires  him  who  wants  her  money.  Begin  poor, 
be  in  urgent  need  of  capital,  borrow  of  a  friend, 
hold  up  your  head,  take  courage,  make  opportunity, 
face  rivalry :  so  shall  you  find  Practice,  who 
already  is  in  love  with  you,  and  win  her,  and 
make  her  pay  your  debts. 

But  here  my  simile,  like  Portia's  father,  is  on 
its  death-bed.  For  there  is  this  difference  between 
her  and  Practice,  that  she  set  the  caskets  side  by 
side,  but  Practice  sets  them  one  inside  another. 
Lead,  gold,  silver  ;  that  is  the  order,  from  without 
inwards,  as  the  anatomists  say  :  and  we  must  open, 
for  her  sake,  not  one  but  all.  First,  the  leaden 
casket,  the  venture  of  faith  :   Who  chooseth  me^  must 


74  CONFESSIO  MEDICI 

give  and  hazard  all  he  hath.  Before  you  go 
further,  count  the  cost  of  this  first  commandment. 
You  make  the  venture,  raise  the  leaden  lid,  read 
the  gold :  Who  chooseth  me^  shall  gain  what  many 
men  desire.  Why,  that  is  Practice ;  all  the  world 
desires  her :  from  the  four  corners  of  the  earth 
they  come,  to  kiss  this  shrine.  Very  well,  young 
man  :  if  you  insist  on  quoting  Morocco's  lines, 
you  must  imitate  his  action.  Come,  open  this 
second  casket.  What  is  inside  it  ?  Oh,  you  know 
that,  as  well  as  any  of  us  ;  quick,  the  key,  and 
up  with  the  golden  lid.  What  have  we  here  ? 
A  third  casket:  Who  chooseth  me  ^  shall  get  as  much 
as  he  deserves.  This  is  the  last  of  them  :  and 
here,  truly,  is  divine  inspiration,  and  you  must 
say  Amen  to  it.  You,  when  the  time  comes  for 
you  to  look  back  at  the  work  of  your  life,  will 
you  care  to  think  of  it  more  than  this,  that  you 
got  what  you  deserved  ?  Take  the  last  of  the 
keys,  and  turn  it.  There  is  the  lady,  an  excellent 
likeness.     Pray,  what  do  you  think  of  her  \ 

The  portrait  of  Practice,  as  you  bring  it,  in 
hands  that  shake  a  little,  to  the  light,  will  I  fear, 
disappoint  you,  at  first.  A  middle-aged,  strong- 
featured  woman,  with  a  lined  forehead  and  pale 
cheeks ;  for  she  is  up  at  all  hours,  and  seldom 
allows  herself  a  holiday.  Her  hands  are  rough  ; 
for  she  works  hard,  and  is  glad  of  employment. 
Her    hair,    touched    with    grey,    is     packed    away 


PRACTICE  75 

under  a  nurse's  cap ;  her  dress  is  of  some  dark, 
serviceable  stuff,  and  of  no  emphatic  fashion  :  and 
she  wears  no  ornaments.  Tired,  quiet  eyes  :  a  nose 
and  a  chin  more  masculine  than  feminine :  a  mouth 
rather  large,  but  well  shaped,  and  well  under 
control :  and,  alas,  a  scar,  from  an  old  hurt  that 
she  got  at  her  work.  You  poor  young  man,  you 
expected  to  find  her  looking  like  Lady  Hamilton 
by  Romney.  But  what  more  can  you  see,  now 
that  you  have  studied,  not  without  a  sinking  of 
your  heart,  this  portrait  of  your  life's  partner? 
Why,  nothing  :  portraits  are  not  prophets.  That 
is  love's  most  urgent  need,  a  portrait  of  twenty 
years  hence.  For  the  present,  be  thankful,  you 
who  are  a  gentleman,  that  Practice  is  a  lady,  a 
born  lady,  you  can  see  that  at  a  glance :  with 
a  good,  sensitive,  kind,  clever  face,  absolutely  free 
from  the  very  least  hint  of  vulgarity.  Her  eyes 
look  straight  into  yours,  and  seem  to  be  reading 
you  more  profoundly  than  you  can  yet  read  her  : 
and  her  lips,  too  severe  for  immediate  kissing, 
give  promise  of  steady,  gentle  sympathy,  and  of 
the  very  best  sort  of  laughter.  Oh,  a  lady,  a 
perfect  lady :  and  I,  for  my  part,  prefer  her  to 
Portia,  whose  jests  are  of  the  stage,  and  her 
charms  require  very  careful  acting. 

Now  that  you  have  seen  the  face  of  Practice, 
you  will  be  wanting  to  know  what  is  her  fortune. 
Let  us  consider,  what  reward  we  have  of  her. 


76  CONFESSIO   MEDICI 

To  make  a  beginning,  let  it  be  granted,  that  our 
reward  is  paid  to  us  part  in  money  and  part  in  kind. 
We  cannot  keep  separate,  as  it  were  in  two  ledgers, 
these  two  incomes  :  nor  can  we  say  exactly,  at  any 
time,  how  much  we  are  worth.  Our  lives  are 
invested  in  the  goodwill  of  friends,  in  the  confi- 
dence of  patients,  in  the  approval  of  the  brethren  ; 
and  in  our  Hospital  record,  and  in  our  intention 
of  sticking  to  work.  All  these  and  the  like  se- 
curities are  but  other  names  for  ourselves.  What 
we  are,  that  we  make :  some  of  it,  but  not  much, 
in  money,  and  the  rest  of  it  in  kind. 

Not  all  of  us  get  as  much  as  we  deserve :  there 
are  exceptions  to  the  rule.  Among  them,  are  the 
many  who  die  young,  or  in  middle-age  ;  and  they 
who  have  taken,  and  cannot  leave,  a  line  of  practice 
not  in  accordance  with  Nature's  plan  for  them  ;  and 
the  ill-starred  Lydgates  whom  a  discordant  home- 
life  crosses  and  keeps  back ;  and  they  who  lose 
health,  or  savings,  or  good  appointments,  through 
no  fault  of  theirs,  and  are  unable  to  repair  that 
loss.  The  list  of  exceptions  is  of  great  length  : 
still,  it  is  not  long  enough,  and  in  a  world  run 
by  Providence  no  possible  list  could  be  long 
enough,  to  annul  the  rule,  that  we  get  what  we 
deserve. 

But,  if  money  were  all  that  we  made  by  practice, 
we  are  far  from  our  deserts.  Many  of  us,  gentle- 
men by  birth,  experts  by  education,  earn  little,  even 


PRACTICE  ^^ 

with  hard  work  ;  and  might  covet  the  takings  of  the 
public-house,  which  provides  such  a  multitude  of 
patients  for  the  Hospital,  without  subscribing  to 
its  funds.  I  wish  the  present  Government  would 
arrange  for  lo  per  cent,  of  the  profits  of  the  public- 
house  to  go  direct  to  the  Hospital,  as  a  slight  return 
for  repairs  executed  on  customers.* 

*  To  write,  in  one  sentence,  of  doctors  and  of  Hospitals 
is  to  be  reminded  of  a  certain  opposition  of  their  interests. 
It  is  no  wonder,  that  we  find  fault,  now  and  again,  with  our 
Hospitals,  even  with  our  Hospitals,  that  they  admit,  or  treat 
as  out-patients,  so  many  people  who  could  ajfford  to  pay  a 
practitioner.  But  this  grievance  is  light,  in  comparison  with 
the  advantages  which  we  obtain  from  their  teaching,  and  from 
the  use  of  their  services.  Besides,  they  do  try  to  check  abuse  : 
but  all  detective  methods  are  somewhat  uncongenial  to  their 
kind  old  hearts.  Of  all  such  methods  of  scrutiny,  the  worst, 
I  think,  is  the  enforcement  of  Hospital  letters.  That  a  dis- 
abled labourer  should  have  to  apply  to  the  tradesmen  in  the 
neighbourhood  for  a  printed  form,  telling  the  Hospital  what 
it  can  see  at  a  glance,  here  is  indeed  an  abuse  of  Hospital 
charity  :  that  a  tradesman  will  not  subscribe  to  his  local 
Hospital  unless  he  gets  a  sheaf  of  letters  for  his  guinea,  here 
is  indeed  an  uncharitable  opinion.  The  authorities  of  the 
King's  Fund  ought  to  make  a  bonfire,  on  His  Majesty's  birth- 
day, of  Hospital  letters.  They  assume  the  vanity  of  the  small 
subscriber,  and  play  up  to  it  ;  they  worry  and  alienate  the 
poor ;  and  the  best  thing  to  do  with  them  is  to  light  your 
pipe  with  them.  They  are  a  survival  of  the  bad  Georgian 
way  of  patronizing  the  unfortunate.  Nothing  can  justify  them, 
unless  it  were  the  existence  of  people  who  would  not  subscribe 
even  to  the  maintenance  of  Heaven,  without  an  Annual  Report 
and  the  right  to  recommend  four  souls  for  immediate  admission  if 
found  suitable  cases. 


78  CONFESSIO   MEDICI 

Of  our  professional  earnings,  what  we  make  in 
money,  I  have  nothing  to  say;  partly  because  they 
vary  so  widely,  and  partly  because  I  do  not  know 
on  what  principles  they  are  determined.  If  Medi- 
cine is  a  trade,  why  should  the  doctor  so  often  work 
for  nothing?  If  it  is  an  art,  what  works  of  art 
does  he  produce?  None,  says  Claude  Bernard, 
Le  medecin  artiste  ne  cree  rien :  but  surely  he  is 
wrong.  The  doctor,  so  far  from  creating  nothing, 
creates  Hfe :  for  he  who  saves  or  prolongs  life, 
creates  more  life.  If  Miss  X  is  seventy,  and  the 
doctor,  by  an  operation,  enables  her  to  live  till  she 
is  seventy-five,  he  has  not  prolonged  the  seventy 
years,  for  they  were  ended  before  he  came  ;  but  he 
has  created  five  brand-new  years.  If  he  had  not 
been  there,  they  would  not  be  here :  that  is  creation. 
He  has  not  lengthened  her  past,  nobody  could ;  he 
has  called  into  existence  her  present  and  her  future : 
and  they  are  she,  therefore  he  has  called  into 
existence  her.  Not  that  he  thinks  much  of  that 
tremendous  act.  For  he  knows  that  the  butcher, 
the  grocer,  the  milkman,  the  people  who  sell 
blankets  and  flannel  garments,  and  most  of  us,  in 
the  case  of  such  an  old  lady,  would  add  the  wine- 
merchant,  all  take  part  in  the  work  of  creation :  and 
I  must  not  forget  the  coal-merchant,  the  baker, 
the  cook,  and  the  housemaid.  Miss  X,  from 
seventy  to  seventy-five,  is  the  achievement  of  a 
syndicate,  and  owes  her  life  to  all  of  them.     Her 


PRACTICE  79 

recognition,  thus  widely  diffused,  must  be  spread 
thin.  She  cannot  take  a  joint-stock  company  to  her 
heart,  crying  My  gallant  preservers :  she  cannot 
endow  them  all.  Suppose  that  she  gives  the  doctor 
what  Pare  would  call  an  honourable  present  and  of 
great  value  :  To  my  kind  doctor y  who  under  Providence 
was  the  means  of  prolonging  my  life.  Why  should  she 
stop  there  ?  The  servants,  the  tradespeople,  the 
very  horses  which  take  her  for  an  airing,  are  they 
not  all,  under  Providence,  creators,  per  quos  ilia  facta 
est  ?  I  begin  to  see  the  meaning  of  that  plural  in 
the  first  chapter  of  Genesis  :  it  is  such  a  business, 
tantae  molis,  to  create  people. 

To  estimate  what  may  thus  be  done,  take  the 
instance  of  a  Hospital  surgeon  in  charge  of  forty 
beds.  Allow  him  six  weeks'  holiday :  and  put  the 
average  stay  of  his  patients  in  Hospital  at  three 
weeks.  That  gives  him  600  patients  a  year.  Take 
any  ten  of  them.  Of  these  ten,  let  us  guess  that 
one  dies,  one  is  none  the  better  for  treatment,  and 
three,  being  cured  of  maladies  which  could  not 
shorten  life,  gain  nothing  in  length  of  days.  That 
leaves  five  patients.  Of  these  five,  let  us  guess  that 
two  gain  ^yq.  years,  two  gain  ten  years,  and  one 
gains  thirty  years.  That  gives  a  gain  of  sixty  years 
on  ten  cases,  or  3600  years  on  600  cases.  In  twenty 
years,  at  that  rate,  he  will  have  saved  72,000  years 
of  other  people's  Hves.  Of  course,  he  cannot  alone 
claim  them  ;    many  minds  and  hands  are  at  work 


So  CONFESSIO   MEDICI 

with  him.  Still,  the  years  are  saved ;  and  that, 
free  of  charge. 

Many  and  great  are  the  rewards  in  kind  which 
we  have  of  practice  :  the  world  never  seems  tired 
of  telling  us  how  thankful  we  ought  to  be  for 
our  blessings.  And,  truly,  we  are.  The  depth  and 
the  width  of  our  work,  its  bewildering  diversity, 
its  vivid  discoveries,  its  science,  all  these  make  us 
happy.  So  does  its  humanity,  so  rich  in  the  friend- 
ship and  the  goodwill  of  our  patients.  I  hesitate  to 
allude  to  their  gratitude,  because  Modern  Thought 
is  inclined  to  explain  away  gratitude  :  still,  there  it 
is,  and  we,  not  being  the  least  bit  like  Wordsworth, 
and  seeing  many  sights  that  oftener  leave  us  mourn- 
ing, are  very  fond  of  gratitude. 

Further,  we  have  this  reward  of  practice,  that  we 
are,  within  ample  limits,  independent  of  all  forms 
and  ceremonies.  So  long  as  we  do  our  work  well, 
nobody  cares  what  we  believe,  what  we  look  like, 
or  how  we  vote.  Wherever  we  go,  we  are  taken 
for  granted,  and  the  world  neither  asks  for  our 
passports  nor  suspects  our  motives  nor  doubts  our 
word.  We  have  nothing  up  our  sleeves.  Nowhere 
need  the  doctor  feel,  if  the  phrase  may  be  pardoned, 
out  of  it :  save  that  he  may  be  embarrassed  by 
sudden  admission  inside  a  sacred  circle  of  hopes 
and  fears  all  spinning  round  a  case  that  he  has 
never  seen  before.  We  come  natural  to  people ; 
which  is  more  than  can  be  said  of  every  profession. 


PRACTICE  8 1 

It  is  not  an  honour,  to  come  natural  to  people ; 
he  who  does  that,  travels  in  very  queer  company : 
still,  it  is  a  pleasure.  Everywhere,  from  the  Smart 
Set,  whatever  that  may  be,  to  the  slums,  and  we 
know  better  than  most  folk  what  the  slums  are, 
we  are  understood  and  welcome.  Fm  so  glad  you 
are  here^  says  the  grand  house,  all  huddled  under 
the  blow  which  has  fallen  on  it ;  the  house  hardly 
knows  itself,  the  invitation-cards  over  the  mantel- 
piece have  an  air  of  mockery,  the  sounds  of  the 
street  are  insufferable,  the  very  window-blinds  are 
tugging  at  their  cords  to  be  let  down.  Fm  so 
glad  you  are  here,  says  the  little  house  in  the  slums. 
Come  along  quick,  doctor,  she's  awful  bad.  Of  course, 
we  must  not  be  proud  that  we  are  wanted.  The 
cat's-meat  man,  for  instance,  is  not  proud  that  the 
cats  want  him,  and  come  twisting  out  of  every 
area.  Still,  if  I  were  he,  I  should  try  to  be  glad 
of  such  a  welcome.  But  to  be  wanted  by  men 
and  women,  to  come  natural  to  them  in  time  of 
trouble,  is  a  very  different  matter,  and  may  fairly 
be  called  a  career. 

It  is  said  that  any  doctor  who  holds  a  Court 
appointment  enjoys  thereby  a  certain  privilege.  If 
he  is  on  his  way  to  the  Palace,  and  his  carriage 
is  stopped  by  the  passing  of  the  Household  Cavalry, 
he  may  in  his  turn  stop  them,  and  drive  straight 
through  the  little  procession.  I  should  love  to 
see    that.     Imagine    the    scene,    those    resplendent 


82  CONFESSIO   MEDICI 

horsemen  all  held-up  by  one  doctor,  like  the  sun 
and  the  moon  in  the  Book  of  Joshua :  see  the 
honest  pride  of  the  doctor's  coachman,  as  the  glitter- 
ing line  of  helmets  and  cuirasses  halts,  with  a  back- 
ward shock,  like  so  many  coal-trucks.  Cedant  arma 
togae.  The  onlookers  laugh,  and  stare :  and  one  or 
two,  as  the  carriage  trundles  past  them,  lift  their 
hats.  Here  is  a  true  figure  of  the  doctor's  life. 
He  goes  straight  to  his  work,  and  is  let  through 
to  it  without  delay  or  hindrance :  his  business  is 
privileged,  his  authority  admitted,  his  presence 
explains  itself  The  forms  and  conventions  which 
impede  society  do  not  interfere  with  him,  and  he 
can  drive  right  through  the  middle  of  them  on 
his  way  to  an  urgent  case.  At  once,  he  comes 
natural  into  lives  all  scared  and  shaken  by  some 
disaster  so  unexpected  that  he  seems  the  one  natural 
event  in  the  house.  Oh,  we  have  our  faults,  and 
may  be  made  to  look  very  funny  on  the  stage 
or  in  a  novel :  but  life  is  not  measured  that  way. 


THE    DISCIPLINE    OF   PRACTICE 

All  of  us,  while  we  are  students,  wonder  what 
we  shall  make  of  practice :  but  some  of  us  forget 
to  wonder  what  practice  will  make  of  us,  and  how 
we  shall  stand  its  discipline.  That  the  discipline 
is  there,  we  know ;  for  no  work  worth  doing  is 
without  discipline  :  but  we  seldom  trouble  ourselves 
to  anticipate  in  thought  its  methods  and  its  purposes. 
Of  course y  we  say.  Things  will  be  slow  and  uphill  at 
firsts  but  I  dont  mind  that :  and  we  reckon  with 
confidence  on  the  usual  sequence,  first  the  lean 
years,  then  success,  and  at  the  last  a  comfortable 
and  honoured  old  age,  with  a  garden,  in  a  pleasant 
neighbourhood  not  too  far  from  London.  This 
forecast  does  not  compel  us  to  see,  as  we  ought, 
that  when  we  take  our  work  in  hand  it  takes  us 
in  hand,  and  chastises  us.  Nothing,  in  practice, 
is  more  certain  than  its  use  of  the  scourge ;  and 
we  need  not  go  outside  the  day's  work  to  learn 
obedience.  Talk  of  the  patience  of  Job^  said  a 
Hospital-nurse,  Job  was  never  on  night-duty.     She 

83 


84  CONFESSIO   MEDICI 

had   found   the   discipHne  of  practice ;    and   it   had 
found  her. 

Consider,  first,  this  instrument  of  the  discipline ; 
that  we  live  under  responsibility,  and  go  in  fear 
of  making  a  mistake.  In  every  science  and  every 
art,  in  every  business  and  every  trade,  mistakes 
are  made:  they  are  a  part  of  all  men.  But  doctors 
practise  their  science  and  their  art  on  life.  With 
that  material,  a  mistake  may  be  irreparable.  You, 
who  are  now  a  student,  keen  over  your  work,  and 
one  of  the  best  men  of  your  year  at  the  Hospital, 
what  will  you  do  when  that  disaster  happens  ? 
How  long  will  it  wait,  before  it  happens?  Indeed, 
it  may  happen  before  you  leave  the  Hospital.  Say 
that  you  are  a  House-physician  or  a  House-surgeon, 
hard-worked,  sometimes  over-worked,  careful,  gentle, 
diligent  —  oh,  let  us  say,  and  have  done  with  it,  that 
you  have  every  virtue  under  Heaven  —  yet  the  blow 
may  fall,  before  the  end  of  your  term  of  office, 
on  some  man,  woman,  or  child  under  your  care ; 
fall,  before  your  death,  on  one  or  more  than  one 
of  your  patients.  Look  this  fact  in  the  face,  now, 
before  it  comes  into  your  life.  People  talk  of 
the  Fine  Arts :  but  what  art  is  so  fine  as  Medicine, 
which  works  in  lives,  and  cannot  correct  its  proofs, 
or  begin  with  a  sketch,  or  waste  its  fabrics,  or 
rehearse  its  effects,  or  use  a  model ;  and,  by  a 
mistake,  injures  not  an  image  of  life,  but  life  ? 
Why,  that  is  just  why  Medicine  is   not  fine.     It 


THE   DISCIPLINE   OF   PRACTICE      85 

is  not  the  art,  but  the  stuff,  which  is  so  fine : 
we  must  interfere  with  that  one  substance  which 
is  above  all  else  in  Nature,  the  one  texture,  man, 
infinitely  complex,  infinitely  precious.  We  touch 
Heaven^  it  is  said,  when  we  lay  our  hands  on  the 
human  body:  and  the  doctor  is  bound  to  dose  it, 
to  operate  on  it.  This  fear  of  doing  harm,  which 
is  called  the  strain  of  practice,  does  not  pass  with 
the  passing  of  youth :  it  is  acknowledged  by  a 
famous  surgeon,  in  a  letter  written  when  he  was 
fifty-six.  What  happy  hours  they  were^  he  says,  of  ^ 
a  holiday  just  over,  in  their  contrast  of  carelessness 
with  the  care  of  mind  with  which,  here,  one  goes 
from  one  responsibility  to  another,  and  always  with 
the  thought  that,  while  meaning  to  do  good,  one  may, 
from  carelessness  or  inadvertence,  do  harm. 

Consider,  next,  that  discipline  which  we  receive 
from  cases  which  fail,  through  no  fault  of  ours, 
yet  they  fail.  The  treatment  was  correct :  there 
was  no  offence  either  of  omission  or  of  com- 
mission. Yet,  over  such  cases,  temperament  is 
apt  to  get  the  upper  hand  of  reason.  Our  suc- 
cessful cases,  we  feel,  might  belong  to  anybody : 
but  our  unsuccessful  cases  belong  to  us.  It  is 
true  that  our  leaders  achieve  successes  which  belong 
to  them  alone ;  but,  to  us  of  the  rank  and  file, 
the  argument  seems  not  merely  sentimental,  but 
logical,  that,  where  I  succeed,  the  rest  of  us  would 
have    succeeded;    but,   where    I    fail,  it    is    I    who 


86  CONFESSIO  MEDICI 

fail,  and  not  the  rest  of  us.  I  have  no  doubt, 
that  A  would  still  have  recovered,  if  B,  and  not 
I,  had  been  in  attendance :  but,  if  A  had  died, 
he  was  not  B's  patient,  but  mine.  It  was  very- 
delightful,  when  A  began  to  get  well :  but  that 
does  not  alter  the  fact  that  I  was  not  the  only 
letter  of  the  alphabet  who  could  have  cured  him. 
Indeed,  if  it  had  not  been  for  B's  book  on  the 
subject,  which  taught  me  C's  modification  of  D's 
method,  it  is  possible  that  A  would  not  have 
made  such  a  quick  recovery.  Besides,  his  recovery 
was  not  all  due  to  me :  fcr  he  had  a  good  con- 
stitution, and  the  will  to  get  well,  and  a  wonderful 
power  of  sleeping,  and  two  nurses  :  and  it  was 
Mrs.  A,  now  I  come  to  think  of  it,  who  sug- 
gested the  champagne.  In  brief,  the  success  was 
mine  as  my  thermometer  and  my  stethoscope  are 
mine :  everybody  has  the  like  of  them.  And 
now,  when  I  meet  old  A,  and  he  says,  as  he 
always  does,  like  a  clock  striking.  My  dear  fellow ^ 
by  God' s  mercy ^  you  saved  my  life^  I  think  of  God's 
mercy  as  a  thousand  incalculable  forces  all  meeting 
at  A ;  and  am  sure,  that  any  doctor  could  have 
done  that. 

Later,  I  attended  A's  son,  who  died.  Nothing 
could  have  saved  him,  I  was  not  at  fault,  I  got 
another  man  to  see  him  with  me,  the  treatment 
was  all  right,  it  was  a  hopeless  case  from  the 
beginning.     All    the   same,  the  failure,   the   dismal 


THE   DISCIPLINE   OF   PRACTICE      87 

going-out  of  young  A,  the  disappointment,  were 
mine  :  it  was  I  who  had  to  watch  him,  and  to 
worry  myself  imagining  that  I  might  be  doing 
something  better  for  him.  He  was  my  patient, 
he  suffered  under  me,  passus  et  sepultus  est:  and 
I  heard  afterwards  that  old  A  said,  The  doctor 
saved  me:  I  wish  to  God  he  had  saved  my  hoy 
instead  of  me. 

I  have  put  these  two  cases  as  in  my  own 
practice  ;  but  I  am  thinking  of  another  man,  who 
carried  about  with  him,  always,  the  sense  that  his 
unsuccessful  cases  were  nearer  to  him  than  his 
successes.  It  did  him  no  good,  nor  his  patients 
either ;  the  last  thing  that  he  wanted  was  a  poor 
opinion  of  himself,  and  he  was  only  tempting  peo- 
ple to  take  him  at  his  own  valuation :  but  he  could 
not  break  himself  of  this  habit  of  mind.  There 
is  no  name  for  it,  and  it  neither  deserves  praise 
nor  helps  practice  :  still,  as  a  part  of  the  discipline, 
as  a  purge  for  pride,  I  commend  it  to  students. 
Gentlemen,  you  attend  a  patient,  who  recovers ; 
and  you  know  that  he  would  have  recovered 
under  any  doctor  as  good  as  you  are.  You  attend 
a  patient,  who  dies  ;  and  you  know  that  he  would 
have  died  under  any  doctor  :  but  he  died  under 
you.  The  two  events  do  not  balance :  the  re- 
covery of  the  one  does  not  sweeten  the  death  of 
the  other.  A  successful  case  is  like  sunshine,  or 
music,  or  food,  which  a  man  enjoys  as  they  come, 


88  CONFESSIO   MEDICI 

but  they  come  to  everybody :  an  unsuccessful  case 
is  a  more  intimate  experience. 

These  methods  of  discipline  are  of  our  own 
invention,  and  we  chastise  ourselves.  But  we  also 
suffer  chastisement  at  the  hands  of  our  patients, 
and  at  the  hands  of  the  brethren.  Consider,  first, 
in  what  measure  we  are  subject  to  public  opinion, 
and  for  what  good  purposes. 

We  have  to  bear,  now  and  again,  gossip,  ill- 
will,  distrust,  the  proud  man's  contumely,  the 
insolence  of  office.  There  really  are  people, 
happily  they  are  rare,  who  dislike  all  doctors,  and 
are  full  of  stories  against  us,  and  sure  that  the 
chemist  is  not  only  cheaper,  but  safer,  and  quite  as 
gentlemanly,  and  much  nearer.  In  the  silly  season, 
but  they  never  seem  to  go  out  of  season,  they 
write  in  this  or  that  paper,  under  the  head-Hne, 
Are  Doctors  Avaricious?  or,  it  may  be.  Ought  we 
to  pay  for  Health?  To  them,  we  are  Shylock ; 
they  even  go  back  to  the  old  idea,  which  to  my 
thinking  was  the  true  idea,  of  a  comic  Shylock. 
And,  in  every  place,  there  is  gossip,  and  one  or 
more  idiots  who  wound  characters  to  kill  time. 

As  for  gossip,  we  are  none  of  us  perfect,  and 
some  of  it  is  true ;  and  the  rest  we  can  alleviate. 
Like  the  pilgrim,  condemned  to  walk  to  Rome 
with  peas  in  his  shoes,  who  accepted  the  penance, 
but  boiled  the  peas,  so  is  the  solvent  action  on 
gossip  of  a  good    temper   and   a   clear  conscience. 


THE   DISCIPLINE   OF   PRACTICE      89 

But  the  young  doctor,  the  new  doctor,  in  a 
gossipy  house,  must  never  be  off  his  guard.  He 
has  seen  and  prescribed  for  his  patient,  and  has 
said  all  that  need  be  said  to  the  friends ;  and  there 
is  tea,  and  what  seems  a  favourable  opportunity 
for  extending  the  practice.  Trust  them  not,  young 
man :  put  your  fingers  in  your  ears,  and  flee  from 
the  City  of  Destruction  of  Reputations.  If  you 
must  stay,  do  not  stay  long,  and  keep  the  door 
of  your  lips.  Talk  of  the  patient,  of  the  weather, 
or  of  the  proposition,  which  will  as  surely  as  the 
bread-and-butter  be  handed  to  you,  that  There  is  a 
good  deal  of  illness  about.  Avoid  all  topics  of 
Church  and  State,  quote  neither  poetry  nor  prose, 
give  neither  censure  nor  approval  to  music  and 
the  drama,  hide  your  liking  for  any  art  but  your 
own.  Leave  behind  you,  for  gossip  to  lap,  a 
saucerful  of  the  milk  of  human  kindness.  Never 
mind  about  producing  a  favourable  impression ; 
produce  this  one  impression,  that  you  know  your 
work,  and  that  it  will  not  be  your  fault  if  the 
mixture  fails  to  relieve  the  patient  upstairs :  and 
then  flee. 

Beside  gossip,  which  is  the  discipline  of  our 
tempers,  we  have  to  bear  opposition,  which  is  the 
discipline  of  our  convictions.  The  anti-vaccina- 
tionist,  the  anti-vivisectionist,  and  the  Christian 
Scientist,  are  against  us.  So  much  the  better  for 
our  faith  in  our  calling.     And,  of  course,  we  have 


90  CONFESSIO   MEDICI 

no  quarrel  with  anybody  who  honestly  wants  to 
know  why  we  believe  in  the  protective  efficacy  of 
vaccination,  the  necessity  for  experiments  on  animals, 
and  the  reality  of  disease.  Our  quarrel  is,  and 
should  be  fiercely  maintained,  against  the  chief 
offenders,  the  Societies,  the  paid  officials,  the 
itinerant  lecturers  with  their  platform  facts.  Yet  I 
advise  the  young  doctor  not  to  rush  unarmed,  not 
even  to  the  defence  of  science  and  ethics.  Our 
opponents  fight  us  with  platform  facts ;  we  must 
beat  them  with  true  facts.  I  advise  all  students, 
when  they  have  time,  to  get  a  fair  knowledge  of 
these  three  subjects  ;  which  cannot  be  done  without 
steady  reading.  Not  only  their  duty  to  their  pro- 
fession, but  their  own  interests,  urge  them  to  be 
thus  definite :  neither  the  profession,  nor  the  public, 
admires  Mr.  Facing-both-ways.  And  it  is  well, 
also,  to  keep  close  at  hand,  for  reference,  a  store 
of  instances  and  figures ;  for  we  ought  to  be  as 
firm  on  the  right  side  as  our  opponents  are  fluent 
on  the  wrong  side. 

But,  if  we  are  to  fight  Christian  Science,  we 
must  make  haste :  for  it  will  not  long  survive  its 
founder.  It  will  die  before  it  gets  to  the  poor. 
Not  that  it  shows  any  great  anxiety  to  get  to 
the  poor,  so  long  as  it  can  get  at  the  rich.  It 
will  go  downhill  quick,  for  it  is  not  strong :  how 
could  it  be,  with  such  a  family  history,  with  Fear 
for  its  father,  and  with  such  a  Mother  ?     See  how 


THE   DISCIPLINE   OF   PRACTICE      91 

delicate  it  is.  It  says  nothing,  or  next  to  nothing, 
about  our  sins  ;  does  just  mention  them,  but  tends 
to  explain  them  away  as  illusions.  It  appeals  to 
our  belief  in  our  own  cleverness ;  hints  at  a 
philosophical  superiority,  a  purer  vision,  a  rarer 
atmosphere ;  suggests  to  me,  that  Plato  and  I 
would  find  a  lot  to  talk  about,  and  that  most 
people  are  in  darkness  but  I  am  in  light.  Its 
one  vital  doctrine  is  this,  that  God  is  real.  What 
then  is  the  God  of  Christian  Science  ?  He  is,  if 
you  unwrap  him,  the  Infinite,  the  One,  the  All, 
nierum  Ens,  pure  Being :  above  superstition,  above 
anthropomorphism,  above  the  comprehension  of 
bishops,  priests,  and  deacons,  especially  deacons. 
This  comfortless  word  Being,  whether  in  Greek, 
Latin,  or  English,  always  leaves  me  where  it  finds 
me.  Still,  in  this  high  creed,  we  must  recognize 
an  air  of  Aristotle,  a  sense  of  freedom,  and  an 
exercise  of  the  reason,  which  must  all  of  them, 
especially  the  last,  be  very  refreshing  to  fashionable 
society.  Here,  in  this  cult  of  Being,  we  have,  if 
the  phrase  may  be  forgiven,  a  very  large  order. 
For  you  cannot  worship  merum  Ens  without  paying 
for  that  intellectual  treat.  If  nothing  is  real  but 
pure  Being,  and  we  must  lift  up  our  thoughts  all 
that  tremendous  way,  or  nowhere,  then  it  is  plain 
that  health,  comfort,  and  life  are  no  more  real 
than  sickness,  pain,  and  death.  If  the  black 
squares    on    the    chess-board    are    not  real,  neither 


92  CONFESSIO   MEDICI 

are  the  white :  and  a  strong  spine  is  just  as 
illusory  as  a  weak  one.  Christian  Science,  on  its 
own  showing,  has  only  substituted  one  set  of 
illusions  for  another.  Look  at  this  advertisement^ 
say  the  proprietors  of  a  soap  or  a  pill,  and  you 
see  green  on  a  red  ground.  Shut  your  eyes^  and  you 
see  red  on  a  green  ground.  That  is  how  the  pro- 
prietors of  Christian  Science  capture  men.  There 
must  be  much  virtue  in  a  soap,  if  you  can  see 
its  name  with  your  eyes  shut :  and  red  on  green 
must,  of  course,  be  more  real  than  green  on  red, 
because  green  on  red  is  what  you  see  with  your 
eyes  open,  just  like  ordinary  people.  It  comes 
to  this,  that  the  Christian  Scientist,  though  she 
sounds  very  subtle,  is  not;  for  she  has  two  Gods, 
one  to  explain  her  pleasures,  and  the  other  to 
explain  away  her  pains ;  one  popular  and  in  touch 
with  the  world,  the  other  metaphysical  and  not  in 
touch  with  the  world. 

The  testimonials,  at  the  end  of  the  official  book, 
are  sad  reading.  Here  are  the  obsessed,  they  who 
cannot  help  thinking  of  their  insides,  and  watch 
for  symptoms,  and  talk  of  diseases,  and  read  medical 
books,  and  are  very  sensitive,  and  never  know  what 
it  is  to  feel  well.  The  neurotic  man  who  lost  all 
liking  for  tobacco,  thanks  to  Christian  Science ;  and 
the  diphtheritic  child  who  coughed  up  some  mem- 
brane, thanks  to  Christian  Science,  and  sang  a  hymn  ; 
and   the   lady  who  had  such  a  bad  time  with  her 


THE   DISCIPLINE   OF   PRACTICE      93 

first  baby,  and  such  an  easy  time,  thanks  to  Christian 
Science,  with  her  second  —  they  all  are  witnesses. 
You  note,  especially,  that  if  a  man  is  in  such  pain 
that  he  cannot  fix  his  mind  on  Mrs.  Eddy's 
methods,  he  may  have  morphia  till  he  can  ;  and 
that  surgical  cases,  for  the  present,  had  better  be 
left  to  the  surgeon,  till  the  world  has  more  faith : 
but  you  are  not  told  which  cases  are  surgical  and 
which  are  medical.  I  should  like  to  collect  and 
publish  what  our  chief  physicians  and  surgeons  know 
of  the  works  of  Christian  Science.  But  apart  from 
its  works,  and  the  ill-gotten  gains  of  its  proprietors, 
I  hate  its  faith ;  and,  if  it  were  going  to  stay  in 
this  world,  I  should  thank  my  God  that  I  am 
not. 

Beside  that  discipline  of  practice  which  we  impose 
on  ourselves,  and  that  which  our  patients  and  the 
public  impose  on  us,  there  is  the  inner  discipline 
of  the  brotherhood,  the  scourge  of  competition. 
Always,  year  in  year  out,  we  work  under  the  crack 
of  that  whip.  It  is  no  wonder,  that  some  students 
dread  starting  in  practice,  and  cling  too  long  to 
resident  or  travelling  appointments.  For,  say  what 
we  will  of  the  excellence  of  competition,  the  fact 
remains,  that  practice  is  the  breaking  of  dreams. 
Inside  the  precincts  of  the  Hospital,  we  were  safe 
and  at  home ;  she  mothered  us,  sheltered  us,  made 
room  for  us  all,  and  there  was  no  fighting,  more 
than    a   friendly   contest   for   a   prize  or  a    House 


94  CONFESSIO   MEDICI 

appointment.  Nowhere,  in  the  imagery  of  Heaven, 
is  it  presented  as  a  competitive  system :  and  the 
candidati  are  not  candidates.  It  is  true,  that  practice 
has  its  golden  times,  when  the  discipHne  is  remitted. 
But  the  gold  is  rare  :  and  is  mixed,  in  Hfe's  till, 
not  only  with  silver  but  with  coppers,  and  here  and 
there  a  bad  coin. 


THE    SPIRIT   OF    PRACTICE 

Our  admission  to  practice  might  be  made  a  more 
imposing  ceremony  :  but  we  have  no  spare  imagina- 
tion, in  our  profession,  for  any  such  uses.  We 
keep  it  all  for  scientific  purposes  ;  or  we  should 
see,  in  that  row  of  examiners  right  and  left  of  the 
President,  the  curve  of  a  presbytery :  and  there 
would  be  appropriate  rites,  and  then  a  little  pro- 
cession of  happy  young  men,  from  the  Examination 
Hall  on  the  Embankment  to  the  Royal  College 
of  Physicians,  which  would  be  indeed  a  procession 
of  the  unemployed.  Or  the  authorities  might  prefer 
to  revive  the  method  of  Greece,  and  to  administer 
to  us  the  Oath  of  Hippocrates  : 

I  swear  by  Apollo  the  Healer,  and  Aesculapius,  and  Hygieia, 
and  Panacea. 

And  I  call  all  Gods  and  Goddesses  to  witness,  that  I  will, 
according  to  my  power  and  judgment,  make  good  this  oath,  and 
this  covenant  which  here  I  sign. 

To  think  of  him  who  taught  me  this  art  as  I  think  of  my 
parents.  To  hold  my  life  as  his  life,  and  to  give  him,  in  the  time 
of  his  need,  a  share  of  my  belongings.  To  consider  his  sons  as 
my  brothers,  and  to  teach  this  art,  to  such  of  them  as  wish  to 
learn  it,  without  payment  or  agreement. 

95 


96  CONFESSIO  MEDICI 

To  impart  the  doctrine,  and  the  interpretation,  and  the  whole 
learning,  to  my  sons,  and  to  my  master's  sons,  and  to  students 
enrolled  and  sworn  under  medical  law,  and  to  nobody  else. 

And  I  will  use  all  ways  of  medical  treatment  that  shall  be 
for  the  advantage  of  the  sufferers,  according  to  my  power  and  judg- 
ment, and  will  protect  them  from  injury  and  injustice.  Nor  will 
I  give  to  any  man,  though  I  be  asked  to  give  it,  any  deadly  drug, 
nor  will  I  consent  that  it  should  be  given.  Likewise,  I  will  not 
procure  abortion.  But  purely  and  holily  I  will  keep  guard  over 
my  life  and  my  art. 

Nor  will  I  cut  them  that  have  the  stone,  but  will  send  them  to 
men  whose  work  it  is  to  perform  that  operation. 

And,  into  whatever  houses  I  enter,  I  will  enter  into  them 
for  the  benefit  of  the  sufferers,  departing  from  all  wilful  injustice 
and  destructiveness,  and  all  lustful  works,  on  bodies  male  and 
female,  free  and  slaves.  And  whatever,  in  practice,  I  see  or  hear, 
or  even  outside  practice,  which  it  is  not  right  should  be  told 
abroad,  I  will  be  silent,  counting  as  unsaid  what  was  said. 

Therefore,  to  me  accomplishing  this  oath  and  not  confounding 
it,  may  there  be  enjoyment  of  life  and  of  art,  being  in  good 
repute  among  all  men  for  ever  and  ever  :  but,  to  me  transgress- 
ing and  perjured,  the  contrary. 

It  seems  a  pity  that  we  should  tumble  into  our 
profession  in  a  way  that  would  have  shocked 
Hippocrates.  Ages  hence,  it  may  be,  our  admis- 
sion to  practice  will  be  solemnized  with  ceremonial 
observances  proper  to  each  of  our  orders.  But 
nothing  shall  be  said  here  about  our  orders :  for, 
in  the  advance  of  the  whole  profession,  the  lines 
between  them  get  crossed  and  shifted.  Besides,  I 
am  thinking  not  of  the  body  but  of  the  spirit 
of  practice. 


THE   SPIRIT   OF   PRACTICE  97 

Pare,  looking  over  my  shoulder  as  I  write,  says 
that  in  his  time  there  were  three  chief  orders : 
the  barber-surgeons,  the  surgeons  of  the  Confra- 
ternity of  Saint  Cosmo,  and  the  physicians.  "  But 
as  for  me,"  says  he,  "  I  protest  that  I  did  the 
offices  of  all  three  of  them,  and  was  moreover 
nurse,  apothecary,  and  cook  to  my  patients  :  neither 
was  there  anything  in  all  medicine  and  surgery  left 
without  my  hand  put  to  the  work.  Now  I  will 
tell  you,  for  the  better  instruction  of  the  young 
surgeon,  how  I  learned  my  business,  by  the  grace 
of  God.  My  father  was  a  carpenter,  which  is  a 
good  trade  :  he  used  to  make  the  big  linen-chests, 
such  as  they  give  to  the  bride  when  she  leaves  her 
home.  I  had  but  little  schooling,  no  more  than 
what  Monsieur  le  Cure  taught  me.  Then,  one 
day,  when  I  was  but  a  boy,  Laurence  Colot  came 
to  Laval,  to  cut  a  man  for  the  stone  :  and  when 
I  saw  the  stone,  I  said  to  myself  that  I  would 
be  a  surgeon.  So  my  father  apprenticed  me  to 
a  barber-surgeon,  I  have  forgotten  his  name.  I 
shaved,  cut  hair,  dressed  wigs,  and  sold  pomades  ; 
I  bled  and  I  cupped  the  customers,  and  opened  many 
abscesses,  and  minded  the  shop :  it  was  a  dog's 
life.  My  only  chance  of  a  lecture  or  a  book  was 
at  daybreak,  or  after  nightfall,  and  then  it  was  in 
Latin,  and  I  leave  you  to  judge  what  fine  lectures 
they  were.  Truly,  I  was  thankful  and  glad,  when  I 
got  work  at  the  great  Hospital  in  Paris.     I  prepare4 


98  CONFESSIO   MEDICI 

the  dissections  for  Sylvius  his  lectures,  and  examined 
the  bodies  of  them  who  died  in  the  Hospital ;  and  I 
helped  at  many  operations  of  surgery,  not  without 
much  lopping-ofF  of  limbs,  and  saw  many  cases  of 
the  plague  ;  I  was  never  in  want  of  a  job.  Some 
recovered,  the  rest  died,  according  to  the  nature  of 
their  wounds  and  maladies.  In  one  winter,  I  had 
the  charge  of  four  frost-bitten  noses  :  and  one  of 
the  Sisters  of  the  Hospital  taught  me  how  to  make 
a  very  excellent  ointment.  I  must  not  forget  to 
say  that  there  was  a  Commission,  of  eight  citizens 
of  Paris,  to  reform  the  Hospital.  I  protest  before 
God  that  we  had  no  need  to  be  reformed  :  and 
that  I  loved  the  Hospital,  and  never  refused  to 
help  any  sick  person,  no,  not  even  in  the  middle 
of  the  night.  Then,  though  I  was  not  yet  admitted 
to  the  Company  of  the  Barber-surgeons,  I  took 
service  under  Monsieur  de  Montejan,  and  went  off 
to  the  wars.  But  I  kept  a  foothold  in  Paris,  just 
two  little  rooms ;  and  my  wife  and  I  were  very 
happy  there,  when  I  could  be  at  home.  And,  by 
my  faith,  people  came  to  me,  not  because  I  had  a 
degree  in  Surgery,  but  because  they  knew  that  I 
could  set  them  on  their  legs  again,  if  anybody 
could.  Which  I  did,  by  the  grace  of  God  :  and 
they  were  well  pleased,  and  gave  me  many  honour- 
able presents,  of  great  value." 

He  seems  to    have    forgotten    the   feuds   of  his 
time,  between   the    barber-surgeons,   the    surgeons, 


THE   SPIRIT   OF   PRACTICE  99 

and  the  physicians.  Nobody  would  think,  hearing 
him  now,  that  he  took  a  great  part  in  them,  and 
led  one  order  of  his  profession  against  another. 
As,  in  Florence  or  Perugia,  long  ago,  feuds  tore 
the  city,  and  departed,  leaving  it  half  dead,  so 
Medicine  was  torn  by  the  spirits  of  Aristotle, 
Galen,  and  Saint  Thomas  Aquinas,  possessing  and 
tormenting  its  members,  till  Science,  at  last,  cast 
out  of  Medicine  all  authority  but  her  own.  Pare 
has  forgotten  the  grievances  and  the  medical  politics 
which  were  so  exciting  then,  and  sound  so  strange 
now.  We  still  have,  order  against  order,  one  or 
two  grievances,  but  none  serious  ;  we  are  come  as 
near  as  any  profession  to  Liberty,  Equality,  and 
Fraternity  :  or,  it  may  be,  they  have  come  across 
the  Channel,  exiles  from  Fare's  country,  to  us. 

Of  the  spirit  of  practice,  this  much  may  safely  be 
said,  that  it  does  not  readily  enter  into  a  Hfe  which 
is  full  of  furniture.  It  must  have  opportunity  for 
its  influences  ;  it  cannot  write  on  walls  which  are 
covered  with  pictures,  or  make  its  voice  heard  above 
music  and  much  talking:  the  life  must  be  clear, 
affording  space,  and  observing  silence.  I  have  had 
the  honour  of  knowing  many  great  physicians  and 
surgeons  ;  and  I  see  this  in  all,  or  nearly  all,  of 
them,  that,  when  they  were  young,  they  made  ready, 
for  the  coming  of  the  spirit  of  practice,  apartments 
of  the  utmost  simplicity  :  quiet,  bare,  whitewashed, 
empty  little  rooms.     Some  of  us  block  the    room 


100  CONFESSIO   MEDICI 

with  all  that  we  put  in  it.  I  know  a  man  who 
did  that.  He  crammed  his  brains  with  books,  and 
learned  whole  sciences  by  heart,  and  read  till  he 
could  read  no  more :  that  was  how  he  furnished 
the  room,  and  it  looked  like  the  inside  of  a  second- 
hand furniture  shop,  and  he  could  hardly  move 
without  knocking  down  something,  or  hurting  him- 
self. He  was  a  young  man  with  a  great  deal  of 
taste ;  so  he  decorated  the  room,  very  prettily,  with 
soft-coloured  upholstery,  and  old  engravings,  and 
casts  of  the  Parthenon  frieze,  and  a  piano,  and 
complete  editions  of  the  poets.  Now,  said  he,  the 
place  is  ready,  at  last,  for  the  spirit  of  practice.  But 
it  went  elsewhere.  The  use  of  culture  is  not  to 
help  us  in  practice,  but  to  console  us  for  want  of 
practice,  and  then  it  is  above  rubies.  We  serve 
three  masters,  our  profession,  our  patients,  and  our 
own  people :  where,  in  this  threefold  service,  i 
culture  required  of  us  ? 

Our  profession  would  have  us  obedient  to  its 
rules  and  loyal  to  the  members  of  its  body,  con- 
tributing according  to  our  means  to  the  common 
store  of  knowledge,  and  working  well :  and  it  no 
more  cares  for  culture  than  if  we  were  so  many 
District  Nurses,  and  one  could  hardly  be  anything 
better  than  that.  But  our  patients,  what  do  they 
demand  ?  Set  aside  those  demands  which  may  fairly 
be  called  not  reasonable,  for  infallibility,  for  extra- 
vagant sympathy,  for  perfect  alacrity  to  be  out  all 


r 


THE   SPIRIT   OF   PRACTICE  loi 

night  for  nothing ;  what,  in  reason,  do  they  demand? 
Health,  recovery,  reHef,  or  at  the  worst  some  pro- 
long .tion  of  Hfe.  What  else  ?  When  people  are 
verj  ill,  their  demands  are  not  many.  They  send 
for  u'le  doctor  to  make  them  well,  not  for  the 
pleasure  of  seeing  him.  There  are  times  when  his 
patients  are  interested,  more  or  less,  in  his  private 
affairs,  likes  and  dislikes,  tastes,  politics,  family, 
previous  education,  and  personal  appearance :  it  is 
when  they  are  not  very  ill,  or  nearly  well.  The 
worse  they  are,  the  less  they  note  these  aspects  of 
him  :  and,  when  they  are  very  ill  indeed,  he  might 
stand  on  his  head,  and  they  would  hardly  notice  it, 
but  would  ascribe  his  strange  demeanour  to  the  dis- 
tempered condition  of  their  senses. 

The  patient,  in  his  time  of  peril,  wants  not  us 
but  himself;  he  wants  to  be  himself  again.  So  far 
as  he  wants  us,  he  wants  not  what  we  call  us,  but 
what  we  have  with  us.  That  is  what  he  means  by 
us.  A\:  the  last,  we  are  of  no  use  at  all,  neither 
we  nor  what  we  have  with  us  : 

Nor  bring,  to  see  me  cease  to  live. 
Some  doctor  full  of  phrase  and  fame. 
To  shake  his  sapient  head,  and  give 
The  ill  he  cannot  cure  a  name. 

So  sings  Matthew  Arnold,  if  you  can  call  it  sing- 
ing. That,  now  and  again,  is  our  hard  lot,  to  be 
told.  We  sent  for  you^  because  we  thought  we  ought^ 
but    of  course    we  know   that  you  cant  do  anything. 


102  CONFESSIO   MEDICI 

Here,  at  the  start  of  the  downward  grade  from 
health  to  death,  is  a  patient  with  very  little  the 
matter  with  him  or  her,  well  enough  to  enjoy  a 
talk  with  the  doctor,  and  hardly  needing  what  he 
has  with  him.  Here,  halfway  down  the  grade,  is  a 
patient  far  too  ill  to  take  much  interest  in  the 
doctor,  and  caring  only  for  what  he  has  with  him. 
Here,  at  the  last  step  of  the  grade,  is  a  patient 
dying,  who  wants  neither  him  nor  anything.  The 
doctor,  as  he  descends  this  dolorous  way,  sheds, 
bit  by  bit,  his  non-medical  self,  takes  it  off,  as  a 
man  in  for  a  fight  takes  off  his  coat.  Over  a  very 
urgent  case,  he  may  even  divest  himself  of  his 
manners,  and  nobody  will  notice  whether  he  has 
them  on  or  not :  only,  he  must  have  with  him 
what  is  necessary.  Last,  he  comes  where  he  might 
as  well  not  be  there,  for  all  the  use  that  he 
can  be. 

Thus,  the  proper  field  for  culture  seems  to  be 
among  them  who,  not  having  much  the  matter  with 
them,  enjoy  talking.  But  not  all,  even  of  them, 
enjoy  listening.  I  know  of  one,  who  said  to  a 
friend,  /  dont  want  my  doctor  to  talk  to  me  about  the 
National  Gallery;  which  is  a  shrewd  saying,  and 
has  taught  me  to  avoid  all  such  dangerous  topics. 
Anyhow,  people  who  are  seriously  ill  care  no  more 
for  preciosity  in  us  than  for  gold-dust  in  beef-tea. 
What  they  want  is  a  man  who  has  just  had  and 
cured  a  case  exactly  like  theirs ;  and  he  need  not 


THE   SPIRIT   OF   PRACTICE         103 

be  a  judge  of  anything  outside  their  insides.  It 
is  poor  comfort  to  them,  to  know  that  he  is  very 
fond  of  really  good  poetry. 

Young  men,  whose  pride  bruises  at  a  touch,  are 
apt  to  be  offended,  when  they  are  thus  classed  as 
plumbers  and  glaziers  of  the  body.  Perhaps  they 
have  never  been  seriously  ill,  never  come  to  that 
point  of  sharp  thought  where  the  physician,  the 
surgeon,  the  anaesthetist,  are  your  best  friends, 
your  Godsends,  not  because  they  talk  to  you  about 
the  National  Gallery,  but  just  because  they  do  not 
talk,  but  dose,  anaesthetize,  and  incise  you.  Every 
doctor,  early  in  his  course,  ought  to  stand  at  that 
point.  You  cannot  be  a  perfect  doctor,  till  you 
have  been  a  patient :  you  cannot  be  a  perfect 
surgeon,  till  you  have  enjoyed  in  your  own  person 
some  surgical  experience.  Enjoyed,  I  say,  and  stick 
to  the  word.  Count  the  ways  of  enjoyment.  To 
be  the  dear  object  of  so  much  care  and  friendship, 
to  be  compassed  about  with  hopes  and  prayers,  is 
there  no  pleasure  in  that  ?  To  behave  nicely,  and 
nothing  common  do  or  mean,  upon  that  memorable 
scene,  but  he  on  the  operating-table  Hke  Patience 
on  a  monument,  is  there  no  pleasure  in  that  act 
of  self-control  ?  On  you,  on  you,  rests  the  love 
of  many  hearts,  and  every  pulse  in  the  house  is 
quick  with  thinking  of  you.  Somebody,  these  last 
few  days,  for  I  take  it  that  you  are  married,  or  at 
the    least  engaged,   has    been    at    her  wits'  end  of 


104  CONFESSIO   MEDICI 

miserable  anxiety  for  your  sake  :  and  behold,  this 
morning  early,  she  brings  you  roses  and  lilies,  and 
wears  a  wonderful  mechanical  smile,  a  most  curious 
grimace,  which  makes  her  more  beautiful  than  ever. 
It  is  time  for  the  operation.  You  are,  what  is  so 
rare  in  this  world,  at  rest.  The  very  elements  of 
thought  and  of  will,  the  disposition  of  the  least 
bodily  act,  are  now  to  be  taken  out  of  your  hands. 
Put  them  by  your  side,  and  shut  your  eyes.  Go 
to  sleep  :  do  nothing,  think  of  nothing,  be  nothing. 
Shut  your  eyes ;  go  to  sleep.  Before  you  wake, 
back  in  bed,  the  good  news  of  your  safety  will  be 
rapped  out,  like  a  spiritualist  message,  at  remote 
post-offices  ;  and  kind  people,  ever  so  far  off,  will 
be  saying,  all  in  a  breath.  Oh  my  dear  it  says  doing 
favourably  operation  perfectly  successful  no  immediate 
anxiety  thank  God  best  love  Tomkins ;  and  your  lady 
of  the  roses  and  Ulies,  with  her  pretty  face  all 
smudged  with  crying,  and  one  ear  red  with  listen- 
ing at  the  key-hole,  will  give  you  such  a  kiss  as 
no  man  deserves  to  have  twice.  And  you,  though 
you  feel  horribly  sick,  being  so  full  of  ether  that 
you  reek  like  a  peppermint-drop,  are  proud,  yes, 
and  happy,  and  through  the  fumes  of  the  clinging 
anaesthetic  are  the  captain  of  your  soul. 

Besides,  see  what  you  have  gained  in  practice. 
To  be  ill,  or  to  undergo  an  operation,  is  to  be 
initiated  into  the  mystery  of  nursing,  and  to  learn 
the    comforts  and  discomforts  of  an  invalid's  life  ; 


THE   SPIRIT   OF   PRACTICE         105 

the  unearthly  fragrance  of  tea  at  daybreak,  the  dis- 
appointment of  rice-pudding  when  you  thought  it 
was  going  to  be  orange-jelly,  and  the  behaviour  of 
each  constituent  part  of  the  bedclothes.  You  know, 
henceforth,  how  many  hours  are  in  a  sleepless  night ; 
and  what  unclean  fancies  will  not  let  us  alone  when 
we  are  ill ;  and  how  illness  may  blunt  anxiety  and 
fear,  so  that  the  patient  is  dull,  but  not  unhappy 
or  worried ;  and  how  we  cling  to  life,  not  from 
terror  of  death,  nor  with  any  clear  desire  for  the 
remainder  of  life,  but  by  nature,  not  by  logic.  In 
brief,  you  learn  from  your  own  case  many  facts 
which  are  not  in  text-books  and  lectures  :  and  your 
patients,  in  the  years  to  come,  will  say  that  they 
prefer  you  to  the  other  doctor,  because  you  seem 
to  understand  exactly  how  they  feel.  I  wish  you 
therefore,  young  man,  early  in  your  career,  a  serious 
illness,  or  an  operation,  or  both.  For  thus,  and 
thus  alone,  may  you  complete  your  medical  educa- 
tion, and  crown  your  learning  with  the  pure  gold 
of  experience.  The  crown  of  experience  is  like  the 
crown  of  Lombardy,  a  band  of  iron  set  in  a  band  of 
gold :  and  it  is  believed,  even  now,  by  some  people, 
that  the  iron  of  that  crown  is  more  valuable  than 
the  gold. 

Besides,  see  what  you  have  gained  in  thought. 
I  hesitate  here,  for  I  am  on  disputed  territory.  Of 
course,  no  problem  is  solved,  no  doctrines  are 
shifted,  by  illness.     Only,  as    you    lie    a-thinking. 


io6  CONFESSIO  MEDICI 

this  cleared  space  of  a  few  weeks  does  present  to 
you  an  aspect  of  life  which  your  work  hides  from 
you.  If  the  mind  be  clouded  or  swamped,  all 
aspects  of  life  are  blurred  or  lost :  but,  in  most 
illnesses,  there  are  fine  days,  when  thought  can 
go  out  and  get  a  good  view.  The  feel  of  life, 
at  such  a  time,  may  be  compared  to  the  feel  of 
London,  at  four  o'clock  in  the  morning,  to  a 
man  walking  home  after  a  ball.  The  streets  and 
squares  and  houses  are  the  same  as  ever ;  and  so 
is  he.  The  taste  of  his  pipe  in  his  mouth,  the  echo 
of  the  music  in  his  head,  the  chill  of  the  pavement 
under  his  feet,  are  familiar  to  him;  everything  is 
what  it  always  was  and  will  be,  nothing  is  happening  ; 
and  he  makes  his  way  past  the  shouting  linkmen  and 
the  line  of  cabs  and  carriages,  glad  to  be  out  in 
the  open  air,  and  as  sure  as  Cleopatra  that  there 
is  nothing  remarkable  beneath  the  visiting  moon. 
Only,  as  he  goes,  the  silence,  the  closed  shops,  the 
odd  sense  of  solitary  wakeful  self,  the  brooding  sky, 
the  empty  roads,  begin  to  talk  to  him,  asking  him 
to  see  for  himself  how,  even  in  London,  Nature  is 
omnipresent,  and,  in  the  act  of  labouring  like  a 
machine^  sleeps  as  a  picture.  Then  they  remind 
him  that  all  London  is  but  a  point  in  the  world's 
purpose ;  yes,  and  all  the  world  but  a  point  in  the 
universal  purpose,  or  what  is  the  good  of  the  stars  ? 
He  begins  to  feel  small ;  and  is  surprised  that  he 
was  proud,  half-an-hour  ago,  of  his  excellent  dancing. 


THE   SPIRIT  OF   PRACTICE         107 

A  breeze  of  dawn  comes,  and  raises  a  little  whirl  of 
dust :  and  he  says  to  himself,  being  a  thoughtful 
young  man  for  his  age,  that  the  Anima  Mundi  is 
just  like  that,  and  every  speck  of  dust  is  a  planet. 
If  planets  are  specks  of  dust.  Lord,  what  is  man  ? 
There  is  a  touch  of  light  in  the  East :  and  it  sets 
him  wondering  at  his  own  existence,  continuous  from 
day  to  day.  He  never  thought  of  that  in  the  ball- 
room. There,  he  had  thought  it  romantic  to  dance 
five  times  with  one  partner :  here,  under  the  stars, 
he  finds  more  romance  than  he  had  expected. 
Nothing  has  happened,  he  is  what  he  was,  he  has 
not  changed  a  hair's-breadth,  nor  has  London : 
bricks  and  mortar,  trees  and  sparrows,  have  no 
arguments  in  them,  no  logical  force.  All  the  same, 
the  vision  did  come  to  him. 

So  it  may  be  with  a  man  when  he  is  ill.  The 
silent,  empty  hours,  the  lull  in  the  traffic  of  his 
life,  the  shutters  up  in  the  shop-front  of  his  work, 
have  something  to  say  to  him  :  they  explain  nothing, 
but  they  give  him  a  point  of  view.  They  emphasize 
his  individuality.  It  is  all  very  well,  in  the  vanity 
of  health,  to  call  ourselves  a  succession  of  states 
of  consciousness  :  that  nonsense  is  knocked  out  of 
us  by  a  month  in  bed,  where  we  have  time  and 
opportunity  to  feel  sure  that  we  are  not.  An 
illness,  I  hardly  know  how,  does  tend  to  make  us 
understand  that  matter  and  reality  are  not  inter- 
changeable   terms.     Here,    in    this    sense    of    the 


io8  CONFESSIO   MEDICI 

non-material  reality  of  self,  is  a  thread  worth 
holding.  Especially,  it  is  to  be  found,  and  held, 
in  the  very  act  of  surrender  to  an  anaesthetic. 
For  he,  who  offers  himself  to  be  reduced  to  un- 
consciousness, is  most  conscious  ;  and  the  freedom 
of  his  will  was  never  more  plain  to  him  than  now, 
when  he  lays  it  down.  With  the  first  breath  of 
ether,  he  fiings  a  last  defiance  to  all  that  we  call 
Haeckel,  and  swears  that  it  is  false.  Which  is  a 
fine  experience,  and  cheap  at  the  price. 

Therefore,  since  happiness,  and  insight  into  other 
people's  feelings,  and  even  a  thread  of  philosophy, 
may  be  got  out  of  illness,  I  advise  every  young 
doctor  to  take  his  chance  of  being  a  patient.  But, 
when  he  is  well  again,  and  back  at  work,  he  must 
keep  his  philosophy  to  himself,  not  let  it  come 
near  his  cases.  I  do  not  mean  that  he  will  infect 
them,  but  that  he  may  be  tempted  to  philosophize 
over  them.  The  spirit  of  practice  refuses  point- 
blank  to  have  anything  to  do  with  philosophy  :  and 
quite  right  too.  All  practice,  to  the  great  advantage 
of  our  patients,  is  founded  and  built  on  materialism. 
No  other  foundation  could  bear  for  a  moment  the 
weight  of  the  present  building.  In  practice,  we  take 
it  for  granted,  that  our  fellow-creatures  are  what 
Haeckel  says  that  they  are.  That  is  the  law  of  our 
work,  and  we  are  under  it  from  the  beginning  of  our 
preliminary  studies  to  the  end  of  our  working  lives. 
So  long  as  we  are  in  the  dissecting-rooms  and  the 


THE   SPIRIT  OF   PRACTICE 


:o9 


physiological  laboratory,  materialism  is  content  to 
enslave  us,  and  scarcely  troubles  to  convert  us. 
But,  when  we  advance  from  anatomy  and  physiology 
to  medicine  and  surgery,  it  assumes  a  more  in- 
quisitorial air,  and  loves,  in  the  wards,  to  send  us 
down  on  our  bended  knees.  Look  here^  it  says, 
and  here,  and  here :  and  dont  you  dare  to  bandy 
words  with  Me.  That  is  HaeckeFs  clinical  teaching, 
his  way  of  demonstrating  the  facts  of  pathology. 
These  cases  of  injury  or  disease  of  the  brain,  what 
are  they,  but  brains  injured  or  diseased  ?  If  you 
believe  that  they  are  more  than  that,  put  your  belief 
to  the  test.  Here  is  a  case  of  cerebral  haemorrhage  : 
Cry  aloud,  for  he  is  a  god,  peradventure  he  sleepeth, 
and  must  he  waked.  And  there  is  no  voice,  nor 
any  to  answer.  From  ward  to  ward,  forcing  on  us 
the  one  simple  explanation  of  everything,  dominating 
the  whole  Hospital,  bullying  everybody,  absolutely 
self-satisfied,  rages  Haeckel,  never  in  doubt,  never 
at  a  loss  :  and  carries  us  along  at  his  heels.  This 
is  the  way  we  go  to  school,  we  go  to  school,  we 
go  to  school ;  the  only  way  for  us  to  learn  our 
art.  A  patient  is  a  case,  Latin  casus,  an  occurrence  ; 
that  is  Haeckel's  rule :  and  we  must  practise  what 
he  preaches,  and  take  hold  of  his  hand  tight,  and 
not  let  go,  or  we  shall  get  lost,  or  run  over  at  the 
next  crossing. 

We  cannot  do  better  than    obey  him.     Foolish 
people   talk   as  if  it    were    somehow    the   doctor's 


no  CONFESSIO   MEDICI 

fault,  and  a  rebuke  against  him,  that  every  scrap 
of  his  work  is  saturated  with  materiaHsm.  Why, 
that  is  just  how  he  makes  it  tell.  There  is  no  place, 
in  practice,  for  any  other  form  of  thought.  Here, 
for  instance,  is  a  patient  in  immediate  danger  of 
death,  but  not  quite  past  all  hope  of  recovery. 
To  the  philosopher,  the  poet,  he  is  animula,  hospes 
comesque  corporis.  To  the  doctor,  who  must  deal 
with  him  at  once,  and  that  by  methods  most 
unpoetical,  he  is  neither  hospes  nor  comes  corporis^ 
hyjit]\x^\.  corpus.  We  learned  him  as  fcr^//j,  and  it 
took  us  iiY^  years,  and  some  of  us  more,  to  learn 
him  that  way :  and  we  treat  him  as  corpus^  because 
it  takes  us  all  our  learning  to  treat  him  that  way. 
For  the  sake  of  our  patients,  the  spirit  of  practice 
compels  us  to  work  always  within  the  ring-fence  of 
materialism. 

But  this  wise  compulsion,  this  honourable  law 
of  our  work,  is  a  purely  business  arrangement 
between  the  spirit  of  practice,  on  the  one  hand, 
and  the  practitioner,  on  the  other  hand.  It  is  a 
convention,  a  serviceable  fiction,  a  good  understand- 
ing between  them.  In  every  art,  there  is  convention. 
Observe  this  admirable  subscription-portrait  of  His 
Worship  the  Mayor,  in  his  robes  of  office.  It  is 
dumb,  though  he  is  voluble  ;  it  is  flat,  though  he  is 
not ;  it  cannot  stir,  though  he  is  a  very  active  man. 
This  painted  cloth,  this  idol,  which  everybody 
admires    as    a   work    of  art,    is    the    only    way    in 


THE   SPIRIT  OF   PRACTICE         in 

which  the  artist  could  treat  the  Mayor.  So  we, 
when  we  treat  our  patients,  obey  the  conventions 
of  our  art.  Like  the  postulates  of  Euclid,  which 
enable  him  to  solve  his  problems  and  construct 
his  figures,  they  enable  us  to  solve  our  problems 
and  employ  our  methods.  Euclid  takes  it  for 
granted,  that  he  is  dealing  with  lines  perfectly 
straight;  we  take  it  for  granted,  that  we  are 
dealing  with  automatic  machines  out  of  order.  Both 
assumptions,  alike,  are  but  the  forgeries  of  science. 

Look  back  to  the  time  when  you  were  not  the 
doctor  but  the  patient,  lying  there  and  wondering 
at  the  mystery  of  yourself;  or  to  the  day  of  your 
operation,  when  that  mystery  accompanied  you  as 
you  went  under  the  anaesthetic,  and  met  you  as  you 
came  out  of  it.  You  were  you,  that  day,  and  your 
brain  was  yours,  not  you.  Pick  up  this  thread,  and 
follow  its  guidance.  How  far  does  it  go .?  Never 
mind ;  follow  it,  and  see.  It  has  nothing  to  do 
with  practice  ?  But  practice,  by  and  by,  will  have 
nothing  to  do  with  you.  In  that  day,  you  may 
be  glad  of  a  thread  of  philosophy.  For  the  present, 
submit  yourself,  in  all  your  work,  to  the  spirit  of 
practice ;  accept  the  current  jargon  about  thought- 
cells  and  successions  of  states  of  consciousness :  and 
hide  your  thread  of  philosophy  from  the  derision 
of  Haeckel. 

Here  are  many  pages,  all  to  say  that  the  spirit 
of  practice  regards  neither   culture  nor  philosophy. 


r 


112  CONFESSIO  MEDICI 

This  negative  conclusion  is  but  a  poor  result,  in 
comparison  with  the  kind  things  said  of  us  in 
books  about  good  doctors,  and  in  Hospital-Sunday 
sermons.  But  is  it  not  true,  and  positive,  that  the 
spirit  of  practice  loves  to  enter  such  lives  as  offer 
to  it  neither  adornments,  nor  a  view  out  of  the 
windows,  but  a  bare  room,  and  expectant  silence, 
and  passionate  longing  for  it,  and  for  it  alone  ? 

Nil  ergo  optahunt  homines?  Have  we,  then, 
nothing  to  pray  for  ?  Indeed,  Juvenal's  prayer, 
being  one  of  the  world's  masterpieces,  will  bear 
translation  here.  (We  know  not^  he  says,  how  to 
fray.  We  pray  for  wealthy  glory ^  eloquence^  beauty^ 
strength^  long  life :  and  the  easy-going  Gods  grant  our 
prayers^  and  thereby  we  bring  on  ourselves  misery  and 
ruin.)  "  Well,  then,  shall  men  stop  praying  ?  If 
you  want  my  advice,  you  will  let  the  Gods  them- 
selves decide  what  is  good  for  us  and  useful  for 
our  stations  in  life.  For  they  will  give  us,  not  the 
pleasures  of  the  moment,  but  all  that  is  most  fit 
for  us.  Man  is  dearer  to  them  than  to  himself. 
Still,  that  you  may  have  something  to  say,  some 
prayer  to  go  with  your  foolish  sacrifices,  pray  for 
a  sound  mind  in  a  sound  body.  Ask  for  a  brave 
heart,  wholly  free  from  the  fear  of  death ;  a  heart 
which  reckons  mere  length  of  days  among  the  least 
of  Nature's  kindnesses,  and  can  bear  all  hardship, 
and  cannot  lose  its  temper  over  trifles,  and  covets 
nothing,  and  is  persuaded  that    the    bitter    labours 


THE   SPIRIT  OF   PRACTICE  113 

of  Hercules  have  more  salvation  in  them  than  the 
lust  and  luxury  of  Sardanapalus.  Behold,  I  am 
telling  you  of  those  gifts  which  you  can  give  to 
yourself,  Gods  or  no  Gods." 

But  these  gifts  will  not  suffice.  Pray  to  the 
Gods,  also,  for  a  fair  measure  of  the  love  of  science, 
a  good  memory,  a  quiet  manner,  the  accurate  use 
of  your  hands  and  your  senses,  and  the  necessity  of 
making  money.  Pray  even  for  opposites ;  for 
humility  and  pride,  for  plodding  business-ways  and 
for  the  wings  of  ambition,  for  a  will  both  stubborn 
and  flexible :  and,  above  all,  for  that  one  gift 
which  has  been  the  making  of  the  best  men  in  our 
profession,  the  grace  of  simplicity  of  purpose. 


WREATHS  AND  CROSSES  OF  PRACTICE 

A  florist's  shop,  at  the  height  of  the  fashion,  is  a 

strange  sight.      Roses  out  of  season,  and  carnations 

grown    so    large    that    they    wear    paper    stays    to 

preserve  their  figures  ;  other  less  fortunate  flowers 

dyed,  wired,   or  twisted  in  devices,  or  imprisoned 

in  wooden   shoes  and  china  wheelbarrows  ;   violets 

without  earth,  forget-me-nots  without  water,  crocuses 

growing    out   of  terracotta    pigs,    and    green    grass 

sprouting  over  comic  little  bald  heads.     Across  the 

fragrance  of  the   flowers,   you    seem    to    catch   the 

smell  of  a  restaurant :  and  the  messenger-boy,  going 

oflF  with  an  elaborate  centre-piece  of  poppies,  is  the 

counterpart  of  the  confectioner's  boy  coming  round 

with  the  ices.      Fashion,  you  would  say,  has  ousted 

Nature.     Yet,  as  you  stand  there,  you  become  aware 

that  Nature,   lurking  about  the  shop,  is  watching 

you  with  a  spiteful  smile,   and  will   still   have   the 

last  word :  and  she  has  it,  on  a  label,  slung  in  the 

window.    Wreaths    and   Crosses.     That    is   Nature's 

way.     She  is  not  in  any  hurry,  nihil  per  saltum  facit ; 

everything    comes    to    her   who    waits.       We,   who 

114 


WREATHS  AND   CROSSES  115 

now  order  table-decorations,  and  bouquets  to  match 
frocks,  shall  one  day  have  wreaths  and  crosses 
ordered  to  match  us.  You  catch  your  breath,  for 
a  moment,  at  that ;  and  the  shop  seems  haunted. 
The  white  flowers  are  whispering  one  to  another : 
Are  you  engaged  to-morrow  afternoon?  Tes,  Kensal 
Green,  worse  luck.  They  nod  their  wicked  heads  at 
you.  The  big  white  lilies,  especially,  have  seen  you 
looking  at  the  label,  and  guess  your  thoughts,  and 
share  your  misgivings,  and  are  going  your  way : 
Ave  Caesar,  they  say  with  a  little  laugh,  morituri 
te  salutant.  None  of  them,  for  my  money,  this 
Saturday  evening :  give  me  unconcerned,  unfashion- 
able, jolly  flowers,  that  are  never  in  mourning,  and 
such  as  go  neither  to  funerals,  no,  nor  to  dinner- 
parties :  homely  flowers,  of  all  the  colours  of  the 
rainbow,  and  with  none  of  the  associations  of  the 
cemetery. 

A  wreath  does  not  commit  the  kind  donor  to 
any  expression  of  opinion ;  a  cross  might  seem 
to  commit  him.  Perhaps,  therefore,  a  wreath  is 
safer  :  one  does  not  want  to  appear  to  be  putting 
oneself  forward,  or  pretending  more  than  one  really 
feels.  Yes,  a  wreath,  please,  a  nice  wreath.  Tie 
your  card  to  it :  you  have  paid  your  last  call  on 
your  friend,  and  he  was  out.  Or  shall  it  be  a 
cross  ?  For  he  was  ill  such  a  long  time,  and  did 
so  want  to  get  well.  Shall  we  drive  back  to  the 
shop,    and    tell    them    to    make    it    a    cross,   not  a 


ii6  CONFESSIO  MEDICI 

wreath  ?  Perhaps,  after  all,  we  had  better  not. 
People  are  so  silly,  they  do  notice  such  little  things, 
and  they  always  read  the  cards.  Besides,  there  are 
sure  to  be  lots  of  crosses  ;  there  always  are.  And 
somehow  a  wreath  seems  more  appropriate.  Per- 
haps he  wouldn't  quite  have  liked  a  cross,  himself. 
Indeed,  now  you  come  to  think  of  it,  they  were 
married  at  a  registry-office :  of  course,  that  was  a 
long  time  ago,  still,  they  were.  So  you  send  your 
wreath ;  and  somebody  else,  because  your  friend, 
whether  he  liked  crosses  or  not,  certainly  bore  one, 
sends  a  cross ;  and  then  somebody,  as  scrupulous 
as  you,  sends  a  wreath ;  and  then  somebody  sends 
a  cross  for  this  reason,  that  if  people  do  not  like 
them,  they  ought.  Thus,  at  the  last,  the  whole 
house  is  fragrant  with  these  opposed  emblems. 

Practice,  also,  has  her  wreaths  and  crosses  :  but 
she  is  never  in  doubt  which  to  send,  for  she  does 
not  wait  till  we  are  dead.  Nor  does  she  p  /ay  fast 
and  loose  with  the  difference  between  then  ,  To 
her  mind,  a  wreath  is  a  wreath,  and  a  era  s  is  a 
cross,  patibulum^  as  it  was  in  the  days  of  T  iberius. 
A  wreath  for  the  victor,  and  a  triumph  ^  along 
the  Sacred  Way,  up  to  the  Capitol :  a  cross  for 
the  unsatisfactory  slave,  and  off  with  him  to  the 
Esquiline. 

The  wreaths  of  Practice  are  those  highest  rewards 
which  she  gives  to  our  leaders,  our  victorious 
generals,  and  to  them  alone.     The  cross  of  Practice 


WREATHS   AND   CROSSES  117 

is  failure  in  practice.  Its  weight,  in  each  case,  is 
determined  by  the  rights  and  the  wrongs  of  that 
particular  case. 

Over  failure,  a  man  may  laugh,  or  preserve  a 
dignified  silence,  or  worry  himself  to  bits  :  do  what 
he  will,  he  cannot  get  clear  away  from  the  idea  that 
he  has  himself,  in  some  measure,  to  blame.  Practice 
does  not  desire  that  he  should  thus  get  clear  away. 
What  he  was,  she  says,  is  where  he  is :  and 
where  he  is,  she  says,  is  just  about  where  he  ought 
to  be. 

But  why  should  a  man  be  surprised  at  some 
admixture,  in  his  life,  of  failure  ?  Is  it  to  be  won- 
dered at,  that  now  and  again  we  take  the  wrong 
turning  in  the  maze,  play  the  wrong  move  in  the 
game  ?  It  would  be  a  miracle,  if  we  did  not. 
Why  then  should  we  be  tragic  over  the  sense  of 
failure,  or,  what  is  worse  than  tragic,  theatrical  ? 
To  be  sorry  for  our  faults  is  trouble  enough,  without 
making  a  scene  over  them,  and  them  so  common. 
Let  us  avoid  the  antick  disposition  of  the  penitent 
hero  on  the  stage.  Behind  him  prostrate  on  a 
wooden  rock,  a  paper  moon  rides  in  a  muslin  sky. 
In  front  of  him,  the  footlights,  glassed  in  green,  shed 
a  pale  gloom,  as  from  the  paper  moon.  Beneath 
him,  in  the  bowels  of  the  stage,  the  fiddles  wail, 
the  double-basses  grunt,  in  sympathy  with  such  a 
weight  of  woe.  He  stirs,  he  speaks;  and  lo,  from 
highest  Heaven,  a  ray  of  limelight  falls  on  his  sad 


ii8  CONFESSIO   MEDICI 

face.  He  is  in  real  distress,  his  plans  have  failed, 
and  he  tells  us  that  it  was  his  fault.  He  put  the 
will,  in  a  moment  of  light-hearted  carelessness, 
where  the  villain  found  it.  He  forgot  to  tell  the 
heroine  that  the  wine  was  drugged,  the  plank  sawn 
half-through,  the  letters  forged.  No  wonder  that 
the  fiddles  are  crying  and  shivering,  and  the  larger 
instruments  are  breathing  heavily :  for  here  is 
genuine  tragedy,  which  is  a  series  of  unavoidable 
disasters,  arising  directly  out  of  human  character, 
and  happening  to  somebody  very  important. 

We  are  all  of  us  that ;  and  all  of  us,  in  point 
of  character,  are  more  or  less  at  fault :  and  then, 
direct  from  our  fault,  comes  failure.  We  were 
ardently  in  love  with  Success ;  we  were  going  to 
marry  her,  and  live  happy  ever  after.  The  very 
day  was  fixed  for  the  wedding :  indeed,  we  were 
on  our  way  to  the  church,  when  we  remembered 
that  we  had  forgotten  to  tell  her  about  the  villain. 
Even  as  we  came  up  the  lane,  in  our  best  clothes, 
she,  poor  dear,  all  smiles  and  song,  and  thinking 
only  of  us,  was  walking  that  plank,  and  went  splash 
into  the  deserted  lock.  Oh,  it  is  too  dreadful. 
Tragedy,  tragedy,  let  us  play  up  to  you,  and  fall 
upon  the  ground^  Taking  the  measure  of  an  unmade 
grave. 

Yet,  if  a  man,  disappointed  of  the  fullness  of  his 
hopes,  is  hard  hit  by  that  loss,  it  is  no  laughing 
matter  ;  and,  as  we  admire  him  who  hides  a  hurt. 


WREATHS   AND   CROSSES  119 

so  we  distrust  him  who  does  not  feel  one.  When 
we  ask  a  man,  Does  it  hurt  ?  and  it  does,  we  like 
him  to  say  T'es.  If  he  says.  No,  I  feel  nothing, 
either  he  is  not  speaking  the  truth,  or  there  is 
something  wrong  with  his   nervous  system. 

Consider,  what  is  the  hurt  of  failure  in  practice. 
I  do  not  mean  complete  failure,  the  point  at  which 
a  man  must  either  do  nothing,  or  take  some  new 
occupation :  I  mean  partial  failure,  some  disappoint- 
ment, that  line  along  which  a  man  must  continue 
at  his  work,  the  same  as  before,  what  there  is  of  it. 

He  casts  about  in  his  mind,  to  find  what  has 
happened.  Was  it  self,  or  chance,  or  Providence, 
or  circumstances,  or  an  enemy,  or  what  was  it,  that 
was  against  him  ?  First,  he  takes  himself,  holds 
his  own  character  to  the  Hght,  as  you  may  see  a 
housewife,  in  autumn,  examining  a  blanket.  He 
finds,  of  course,  one  or  two  moth-holes.  Perhaps 
he  was  not  really  practical  in  practice,  but  had 
bookish  views  as  to  the  proper  behaviour  of  diseases; 
or  he  was  a  bit  slow,  unbusiness-like,  a  lover  of 
leisure,  a  bad  hand  at  making  work  ;  or  he  was  a 
bit  quarrelsome,  or  hard,  or  difficult,  or  fantastical ; 
or  he  was  of  the  number  of  those  who  are  proud 
of  being  humble,  who  assert  their  freedom  from 
self-assertion,  and  advertise  their  dislike  of  advertise- 
ment; or  he  was  fond  of  talking  about  himself  to 
people  who  were  aching  to  talk  about  themselves. 
One  or  more  of  these  faults  he   finds   in  himself: 


120  CONFESSIO   MEDICI 

yet,  honestly,  he  cannot  see  that  they  explain  his 
disappointment.  They  had,  he  says,  something  to 
do  with  it.  But  the  fault  and  the  failure  do  not 
balance,  are  not  proportionate.  Over  the  doors  of 
old  cathedrals,  amid  a  labyrinth  of  sculpture,  angels 
weigh  in  balances  the  souls  of  men;  over  the  doors 
of  law-courts.  Justices  hold  empty  balances,  waiting 
blindfold  for  a  job.  All  the  same,  fault  and  failure 
are  not  commensurate.  Fault  is  dynamic :  a  few 
grains  of  fault  can  blow  up  a  whole  edifice  of 
ambition,  and  spoil  the  finest  castle  that  ever  was 
built  in  the  air.  Our  imaginary  man  has  suffered 
that  reverse.  His  castle  still  stands,  but  with  sad 
cracks  in  its  walls,  and  broken  windows,  and  a 
leaking  roof  The  dynamite  went  off:  and  we  need 
not  trouble  to  ask  what  made  it  go  off.  Perhaps 
it  went  off  by  chance.  Anyhow,  he  had  it  there  : 
he  is  himself,  in  a  measure,  the  cause  of  his  dis- 
appointment. 

Then  comes  the  thought,  how  many  lives  are 
affected.  Here,  just  here,  is  the  hurt  of  his  dis- 
appointment, in  its  centrifugal  results  on  circles 
beyond  circles  of  other  people.  The  shaking  of 
his  castle  is  like  the  seismic  waves  of  Mont  Pelee, 
which  were  felt,  again  and  again,  by  every  observa- 
tory in  the  world,  and  are  still  embodied,  somehow, 
in  the  universe.  First,  his  home-circle.  I  assume, 
of  course,  that  he  is  middle-aged,  and  has  given 
hostages  to  fortune.     Solitary    men,   as   they    miss 


WREATHS   AND   CROSSES  121 

the  sweetness  of  making  money,  so  they  avoid  the 
bitterness  of  wanting  it :  young  men,  likewise,  avoid 
that  bitterness,  for  they  are  sure  that  the  sweets 
are  to  come.  Therefore,  our  imaginary  man  is 
middle-aged,  and  has  a  wife  and  family :  and,  as 
his  Hfe  tastes  now,  so  it  will  taste  henceforth. 

Husband  and  wife,  while  they  are  young,  and 
the  baby  is  still  the  baby,  play  at  economy  as  at  a 
game.  They  remind  me  of  that  pleasant  minstrel, 
at  the  swing-doors  of  the  public-house,  who  gets 
melody  out  of  a  coffee-pot  with  holes  cut  in  the 
spout,  or  from  hard  little  strips  of  glass  or  metal. 
They  shall  have  music  wherever  they  go.  To  him 
and  her,  who  can  find  pleasure  in  saving  a  cab-fare, 
and  spend  that  shilling,  arm  in  arm,  quite  seriously, 
on  something  else,  that  she  really  did  want,  this 
discourse  is  not  addressed.  I  envy  and  honour 
them.  Out  of  books,  out  of  good  examples,  out 
of  their  own  hearts,  they  encourage  one  another, 
and  quote  the  whole  anthology  of  the  praise  of 
thrift :  My  father  was  just  as  poor,  at  my  age,  as 
I  am.  My  mother  had  to  do  without  lots  of  things: 
besides,  she  had  such  had  health.  They  invent 
challenges  and  pass-words  of  love  :  Why  didnt  you 
marry  somebody  with  money  ?  That  is  the  challenge  ; 
and  the  pass-word  takes  all  four  lips.  They  surprise 
each  other  with  sixpennorths  of  luxury,  and  have 
a  thousand  plans  for  the  immediate  future,  and 
Aunt  Maria's  fifty  pounds  is  spent  in  fancy  many 


122  CONFESSIO   MEDICI 

times  before  it  comes  to  them.  In  the  profound 
Greek  sense  of  the  word,  they  have  enthusiasm. 
Look  which  way  they  will,  back  or  here  or  ahead, 
they  see  sunshine  :  and  people  ask  them  to  evening- 
parties  because  their  happiness  lights  up  that  dim 
pleasure.  They  find  a  sacrament  in  their  daily 
bread,  and  a  miracle  in  the  coming  of  the  baby. 
To  save,  to  wait,  to  scrape  along,  —  why,  that  is 
what  they  enjoy  ;  that  is  the  way  to  begin,  the 
classic,  heroic,  historic,  romantic,  practical  way  : 
besides,  how  stupid  it  would  be  to  be  rich  now, 
how  vulgar.  See  them,  this  man  and  this  woman, 
setting-out,  hand  in  hand,  heart  in  heart,  into  an 
expectant  world.  I  could  rhapsodize  for  pages  over 
them :  indeed,  if  it  comes  to  that,  they  can  do  it 
for  themselves.  In  all  life,  there  is  nothing  more 
delightful,  more  inspiriting,  than  the  sight  of  their 
bow  in  the  clouds  ;  and  I  hope  that  it  will  be  lost 
not  in  a  sky  of  grey,  but  in  a  sky  all  sapphire. 

But  suppose  the  sky  keeps  grey.  Not  black, 
but  grey  ;  no  storm  clears  the  dull  air  and  washes 
the  streets  of  life  :  only,  the  sky  is  grey,  and  the 
bow  gone.  Oh,  not  a  regular  wet  day,  no  excuse 
for  stopping  indoors,  or  giving  up  any  engagement : 
still,  a  dull  heavy  sort  of  day,  and  rather  cold, 
considering  that  it  ought  to  be  summer.  Slowly, 
the  sense  of  effort  and  of  make-believe  comes 
into  their  game  of  economy.  They  begin  to  long 
to  play  at  something  else.     Once,  they  were  proud 


WREATHS   AND  CROSSES  123 

of  not  being  rich  :  now,  the  most  that  they  can 
compass  is  to  be  proud  of  not  being  ashamed  of 
being  poor ;  and  sometimes  even  that  humble  pride 
breaks,  and  lies  in  the  dust.  Once,  they  could  chaff 
one  another  over  his  earnings,  and  had  a  sort  of 
slang,  for  home-use,  a  love's  lingo,  weird  names 
for  the  tradesmen's  bills,  and  for  his  pocket-money, 
and  her  sewing-machine :  but  that  is  all  left  off 
now,  because  it  hurts  them  both ;  and  he  gives 
her  with  a  sigh  the  week's  takings,  which  he  used 
to  give  with  a  laugh ;  and  each  of  them  is  longing 
to  see  the  other  looking  happy.  Hospitality,  so 
far  as  they  still  exercise  that  grace,  begins  to  lose 
touch  with  the  rest  of  home-life.  Into  their  rare 
festivities,  there  enters  a  hint  of  Macbeth's  feast; 
no  actual  ghost,  nothing  so  gross  as  that :  only, 
on  your  way  back,  you  cannot  help  doubting 
whether  he  and  she,  left  alone,  are  very  cheerful. 
That  is  the  most  dreadful  passage  in  all  Shakspeare, 
when  everybody  has  gone,  the  ghost  and  all  of 
them,  and  Macbeth  is  talking  to  himself,  and  his 
wife  is  looking  at  him. 

Circle  beyond  circle,  the  wave  of  their  disappoint- 
ment spreads.  They  cannot  afford  to  be  generous, 
they  cannot  afford  to  be  charitable.  This  embarrass- 
ment might  be  called  a  negative  trouble :  but  I 
always  have  a  difficulty  in  seeing  any  difference 
between  negative  and  positive.  Not  to  give,  is 
to  withhold.     Say  that  a  well-timed  gift  would  save 


124  CONFESSIO   MEDICI 

a  man  or  a  woman  from  going  to  the  bad.  Is  it 
not  to  say  that  he,  who  withholds  that  gift,  sends 
them  there  ? 

He  and  she  did  so  want  to  be  hospitable  and 
charitable  :  it  seems  such  a  reasonable  desire.  What 
shall  they  do  ?  I  do  not  see  that  they  can  do  any- 
thing. He  has  not  altogether  failed  ;  he  is  only 
a  bit  disappointed,  a  bit  disillusioned.  Oh^  they 
have  much  to  be  thankful  for^  says  their  Httle  world : 
they  have  good  healthy  and  I  do  like  her  so  much. 
That  is  quite  true,  they  have  a  great  deal  to  be 
thankful  for :  but,  for  all  that,  he  and  she,  still 
hand  in  hand,  and  heart  in  heart,  are  bearing  the 
cross  of  practice  between  them. 

Practice,  thank  Heaven,  sends  also  wreaths;  olive, 
laurel,  gold,  she  has  them  of  all  sorts,  I  have  seen 
them  :  and  never,  in  all  the  history  of  Medicine? 
were  they  more  plentiful  and  more  beautiful  than 
they  are  now.  Ah^  did  you  once  see  Shelley  -plain  ^  And 
did  he  stop  and  speak  to  you  ?  Shelley,  indeed.  Why, 
I  hav^e  seen  and  shaken  hands  with  doctors  worth 
a  wilderness  of  Shelleys.  Into  their  keeping,  God 
entrusted  lives  precious  to  the  Empire,  to  be  saved. 
Out  of  their  work,  out  of  their  discoveries,  came, 
and  come,  and  will  come,  health  and  safety  and 
length  of  days  and  delivery  from  pain. 

Yet,  if  we  look  close  at  Medicine,  we  may  doubt 
whether  any  wreath,  that  Practice  has  to  give,  is 
equal    in    value    to    the    wreaths    of  Science.     The 


WREATHS   AND   CROSSES  125 

doctor,  more  and  more,  turns,  for  the  advancement 
of  his  art,  toward  the  physiologist,  the  pathologist, 
and  the  bacteriologist.  From  them,  who  are  not 
in  practice,  whose  work  is  in  the  laboratory,  whose 
language  is  mostly  unintelligible  to  us  practitioners, 
have  come  new  methods,  new  facts :  to  them  we 
look,  and  shall  not  look  in  vain,  for  help  and 
guidance. 


RETIREMENT 

He  who  would  write  a  book,  but  cannot  think  of 
a  subject,  should  plan  a  series  of  short  essays,  each 
on  a  word.  To  that  end,  he  should  open,  at 
random,  a  dictionary ;  and  there  he  will  find,  always, 
a  word  in  want  of  an  essay.  This  method  of  divin- 
ation, the  sortes,  was  once  in  frequent  use ;  and 
may  be  less  foolish  than  it  sounds.  You  open,  at 
random,  a  Bible  or  a  Virgil,  and  take,  as  advisers, 
the  first  words  that  come.  Why  should  you  not  ? 
Say  that  you  cannot  decide  between  two  courses, 
cannot  look  far  ahead :  shall  not  one  of  the 
Hundred  Best  Books,  at  random,  be  as  wise  as  you 
at  sea?  You  are  ready  enough  to  use  a  friend 
that  way,  opening  his  heart  at  random,  and  letting 
yourself  be  guided  by  what  you  find  there.  A 
friend  and  a  book  are  not  so  very  different :  in- 
deed, the  book  may  be  the  truer  prophet,  as  with 
King  Charles  the  First,  who  opened  a  Bible,  and 
found.  Let  his  children  be  fatherless ^  and  his  wife  a 
widow.  None  of  his  friends  had  warned  him  of 
that.     And,  even  on  me,  the  sortes  have  just  dis- 

126 


RETIREMENT 


127 


played  their  power.  For  I  had  headed  this  chapter, 
and  begun  to  write  it,  and  then  I  fell  to  playing 
sortes  with  a  volume  of  Johnson's  Dictionary.  I 
opened  it,  at  random,  six  times :  and  behold,  the 
third  time,  this  very  word  Retirement,  which  I  had 
just  written,  met  my  eyes.  The  other  five  words 
were  Pardon,  Sorrow,  Morality,  Vitality,  and 
Thief:  all  thoroughly  essayable  words,  especially 
Pardon. 

Retirement,  said  the  Dictionary,  is  derived  from 
the  French.  To  understand  the  meaning  of  a  word, 
one  must  observe  and  consider  what  pictures  it 
raises  in  the  mind's  eye.  This  Retirement  gave  me 
three  such  pictures.  First,  I  had  a  vision  of  French 
and  English  thumping  each  other  up  and  down 
Southampton  Water,  or  under  the  walls  of  Calais, 
or  round  and  round  some  old  castle  in  Normandy : 
and  the  French  were  swearing,  I  could  hear  them 
all  this  way  off,  and  across  the  centuries,  that  these 
devils  of  English  were  retiring,  se  retiraient.  Then, 
came  a  curious  vision  of  an  amoeba  under  the 
microscope  :  I  could  see  it  contracting,  till  all  its 
processes  were  indrawn,  and  it  ceased  to  move. 
Then,  I  saw  what  I  took  to  be  the  wilderness,  and 
a  man,  alone  in  the  wilderness,  gone  there  for  that 
one  purpose,  to  be  alone. 

Of  course,  to  play  this  game  of  word-pictures 
as  it  ought  to  be  played,  you  must  have  words 
of  the  right  size.     As    a  rule,  the  size  of  a  word 


128  CONFESSIO   MEDICI 

is  inversely  as  its  length.  For  example,  all  such 
words  as  heterogenesis,  undenominationalism,  and 
diazoamidonaphthalene,  though  two  of  them  really 
mean  something,  and  the  third  is  in  daily  use,  yet 
you  cannot  play  with  them,  because  they  are  too 
small  :  they  raise  feeble,  ridiculous  pictures.  On  the 
other  hand,  such  words  as  love  and  life  and  death 
are  too  large :  they  raise  no  pictures,  only  frames. 
Your  words  must  be  of  the  right  size,  and,  as  it 
were,  of  the  right  shape  :  then,  with  a  little  care, 
you  can  obtain  a  delightful  succession  of  pictures. 
I  only  got  three  out  of  Retirement :  but  some  words 
will  give  you  half-a-dozen,  or  more. 

Of  my  three,  the  first  and  the  last  were  common- 
place. But  the  vision  of  the  amoeba  was  of  great 
value  ;  it  more  than  illustrates,  it  illuminates,  the 
meaning  of  the  word.  To  retire,  se  retirer^  is  to 
draw  back  self;  the  verb  is,  or  was,  active,  govern- 
ing self,  like  conscience,  in  the  accusative  :  and  the 
dictionary  gives  an  instance  of  this  old  use,  He 
retired  himself  into  the  castle.  No  wonder  I  saw 
soldiers.  For  a  soldier,  there  is  always  the  castle ; 
for  a  hermit,  there  is  always  the  wilderness  :  but  let 
us,  in  accordance  with  the  principles  of  physiology, 
begin  with  a  very  humble  organism.  The  amoeba 
is  its  own  castle,  its  own  wilderness ;  it  cannot 
retreat  but  into  itself  When  it  feels  the  need  of 
retirement,  it  merely  contracts.  Its  occupation,  so 
far  as  we  can  see,   is    gone  :  it    neither  thrusts-out 


RETIREMENT  129 

adventurous  feelers,  nor  hunts  after  food,  nor  adapts 
itself  to  its  surroundings,  nor  deludes  medical  students 
into  talking  about  voluntary  movements,  nor  takes 
any  interest  in  its  neighbours.  It  may  be  digesting, 
or  it  may  be  dead  :  a  dreadful  sort  of  retirement,  to 
be  so  inert  as  to  leave  doubt  on  that  point. 

The  amoeba  is  a  warning  to  all  of  us,  against 
the  day  when  we  also  shall  retire.  Having  no 
refuge,  it  simply  leaves  off.  Its  very  name  signifies 
change ;  and  now  it  has  ceased  to  change.  We 
dare  not  do  that ;  we  must  have  a  refuge.  Let 
us  prepare  for  ourselves,  now,  castles  to  withstand  the 
siege  of  Monotony,  and  let  us  fit  ourselves  to  find 
opportunity  in  the  wilderness  of  Superannuation.  If 
we  do  not  betake  ourselves  to  some  resort  outside 
ourselves,  we  shall  not  retire  ;  we  shall  only  contract. 

But  the  amoeba,  when  it  is  weary  of  retirement, 
can  start  again.  We  retire  once  and  for  all,  and 
cannot  a  second  time  come  forth,  suffer  ourselves 
to  be  desired,  nor  blush  to  be  admired.  Over  the 
door  through  which  we  pass,  and  shut  it  behind 
us,  the  red  lamp  is  extinguished ;  we  resign  our 
appointments,  cut-ofiF  our  night-bells,  and  remove 
our  brass-plates  :  I  shall  keep  mine  for  the  last  of 
my  abodes,  when  I  shall  retire  a  few  feet  deeper 
from  my  profession. 

It  is  strange  that  men  should  talk  so  lightly  of 
retirement,  seeing  that  it  can  no  more  be  undone 
than  the   rest  of  our  deeds.     The  explanation   of 


130  CONFESSIO   MEDICI 

this  levity  may  be,  that  retirement  takes  time,  out- 
stays emotion,  and  does  not  lend  itself  to  dramatic 
treatment,  or  to  the  sending  of  telegrams  and 
flowers.  Surely,  in  these  days  of  pageants,  we 
ought  to  devise  a  ceremony  of  retirement,  a  service 
of  surrender.  The  Universities  might  arrange  some 
cheerful  yet  sympathetic  office,  that  should  gather 
into  one  passionate,  formal  act,  the  doctor's 
thoughts,  as  his  work  drops  from  his  hands :  and 
I  think,  also,  that  the  Church  might  suggest  some- 
thing. And,  for  those  of  us  to  whom  University 
and  Church  sound  excessive,  there  should  be  at 
least  a  vellum  address  from  the  Mayor  and  Cor- 
poration, and  a  silver  inkstand,  and  a  band  playing 
Auld  Lang  Syne,  and  tea  and  coffee  downstairs. 
But  the  fact  is,  that  retirement  is  a  lengthy  and 
deliberate  process,  so  sicklied  o*er  with  the  pale 
cast  of  thought  that  it  loses  the  name  of  action. 
To  be  born,  or  to  be  married,  or  to  die,  is  the 
work  of  a  moment :  and  the  clock  records  the 
baby's  first  cry,  the  sudden  cadence  of  the  knotting- 
words  of  the  marriage  service,  and  the  last  sigh  of 
the  breath.  But  we  cannot  thus  time  retirement. 
Kings  and  Queens  and  Cabinet  Ministers  can,  but 
not  we ; 

Now  mark  me,  how  I  will  undo  myself. 
I  give  this  heavy  weight  from  off  my  head. 
And  this  unwieldy  sceptre  from  my  hand ; 
The  pride  of  kingly  sway  from  out  my  heart: 


RETIREMENT  131 

With  mine  own  tears  I  wash  away  my  balm. 
With  mine  own  hands  I  give  away  my  crown. 
With  mine  own  tongue  deny  my  sacred  state. 
With  mine  own  breath  release  all  duteous  rites. 

That  is  how  kings  retire,  and  the  whole  sky 
is  red  with  that  sunset :  but  we,  less  majestical, 
whose  only  language  is  prose,  and  home  our  only 
audience,  we  go  slowly,  feeling  our  way  ;  and  so 
gradual  is  the  action  that  we  hardly  note  the 
finality  of  the  act.  There  have  been  so  many 
plans  and  calculations,  that  the  event  seems  merely 
the  last  of  many  plans,  and  is  no  surprise  to  our 
friends.  Why^  they  say,  he  s  been  retiring  for  ever 
so  long  :  he  was  talking  of  it  last  February^  after 
that  attack  of  influenza.  The  change  from  autumn 
to  winter,  if  you  go  by  the  thermometer,  does 
not  feel  like  an  event.  If  you  want  to  make  an 
event  of  it,  you  must  go  by  the  calendar.  So  we, 
changing  from  the  harvest  of  practice  to  the  frosts 
of  retirement,  go  by  the  thermometer  of  our  hopes 
and  fears,  which  have  a  wide  range,  and  are  slow 
to  settle  down.  If  we  want  to  make  an  event  of 
it,  we  must  go  by  the  calendar  of  our  fates,  in 
which  book  our  retirements  are  precisely  marked, 
just  like  our  births,  marriages,  and  deaths,  one 
day  for  each  event. 

The  act,  or  event,  of  retirement  is  the  same 
for  all  of  us :  but  the  attendant  circumstances  are 
particular  to  each  of  us.     Some  men  are  born  to 


132  CONFESSIO  MEDICI 

retirement,    some    achieve    it,    and    some    have    it 
thrust  upon  them. 

He  who  is  born  to  retirement  is  of  that 
temperament  which  is  called  retiring.  Other  names 
for  it,  in  order  of  merit,  are  these  —  unassuming, 
mild,  soft,  and  feeble.  The  born  retirer  does  not 
understand,  he  never  did,  he  never  will,  how  to 
fight,  force  his  way,  hold  his  own,  and  increase 
his  holding,  advance,  bring  up  reinforcements, 
advance  again,  and  beat  thundering  at  the  gates  of 
Success  :  Open,  open  to  me.  Open,  I  say.  It  is  I, 
The  passion  of  his  profession  flickers  in  him, 
just  keeps  him  warm,  but  will  never  blaze.  He 
was  always  like  that.  In  the  nursery,  he  was  fond 
of  his  toys,  but  let  all  the  other  children  play 
with  them ;  and,  in  the  service  of  that  charity 
which  begins  at  home,  many  were  broken,  and 
he  did  not  mind.  At  school,  he  was  a  good 
boy ;  pleased,  out  of  all  proportion,  with  every 
gradual  inch  of  advancement,  a  remove,  a  word  of 
praise,  full  marks  for  a  set  of  verses,  bookish 
little  triumphs,  all  of  them :  but  the  point  is, 
that  competition  made  them  none  the  sweeter, 
and  full  marks  all  round  would  have  pleased  him 
just  as  well,  if  not  better.  Compelled  to  take 
part  in  athletic  exercises,  he  behaved,  rather  than 
played ;  and  half  was  vexed  at  his  incapacity,  and 
half  was  vain  of  it.  Physically,  he  was  inclined 
toward  cowardice,  and  contrived  to  go  all  his  time 


RETIREMENT  133 

at  school  without  one  thrashing  either  official  or 
otherwise.  Diligent,  polite,  tidy,  punctilious  in 
religion  and  fastidious  over  food,  and  glad  to 
share  both  his  prayers  and  his  hampers  with  other 
boys ;  found  on  the  side  of  the  authorities  in  times 
of  feud,  and  bearing  his  own  authority,  when  it 
came  to  him,  with  provoking  meekness ;  fond  of 
loneliness,  yet  desirous  of  popularity:  self-observant, 
elaborate  —  oh,  who  can  describe  a  boy's  inner 
world  ?  —  but  his  hold  on  the  real  world  was  all 
wrong.  To  fight  and  sweat  and  put  himself  in 
the  way  of  pain,  to  stick  to  his  rights  with  brute 
force  and  bad  language  against  attack  and  strategy, 
to  find  fault  with  heaven  and  earth,  to  mock  and 
rage  and  rebel  —  these  accomplishments  were  not 
in  his  plan,  if  he  had  one,  of  his  life.  He  was 
content  with  his  conscience,  his  books,  his  fair 
record,  his  tepid  sense  that  some  of  us  thought 
well  of  him.  When  he  left,  we  were  neither 
sorry  nor  glad ;  nor  was  he.  School  cut  no  deep 
mark  on  him,  nor  he  on  it.  He  had  wanted  to 
be  good,  had  tried  to  be  good,  had  been  good: 
and  we  had  no  objection  to  that,  or  next  to  none. 
But  he  had  failed  to  fight,  had  worked,  but  had 
not  fought.  At  the  hospital,  he  was  much  the 
same.  There,  of  course,  they  diagnosed  his  case; 
no  actual  disease,  no  real  degeneration :  simple 
weakness,  or  deficiency  of  strength.  This  brilliant 
diagnosis  had  not  occurred  to  the  authorities  at  his 


134  CONFESSIO   MEDICI 

school,  because  they  did  not  know,  there,  what 
he  was  going  to  be,  and  what  sort  of  strength 
he  would  want.  In  practice,  he  did  begin  to  try 
to  fight,  but  without  much  result.  Always,  he 
was  inclined  to  take  the  day's  work  not  as  competi- 
tion but  as  performance ;  not  as  a  good-natured 
scrimmage  for  a  front  place  in  the  crowd,  but  as 
a  walk  through  interesting  streets.  Later,  he 
began  to  persuade  himself,  or  half  persuade  himself, 
that  a  solitary  walk  is  the  best  form  of  exercise. 
Later  still,  he  began  to  be  neglectful  of  honourable 
and  approved  ways  of  self-advancement,  and  to 
feel  a  bit  out  of  heart,  slack,  envious.  So,  at 
last,  the  quiet  verdict  went  round,  that  he  might 
have  done  better.  And  some  of  the  jury,  for 
they  liked  him  —  Heaven,  not  thinking  it  wise  to 
give  him  much  money,  had  given  him  many 
friends  —  said  that  it  was  infernal  hard  lines  on 
him.     But  was  it? 

For  still  the  Lord  is  Lord  of  might : 
In  deeds,  in  deeds.  He  takes  delight. 

But  we  need  not  waste  pity  on  them  who  are 
born  to  retirement.  They  find  pleasure  by  the 
way  ;  it  is  a  kindly  nature,  a  not  ignoble  birthright : 
there  is  much  to  be  said  in  favour  of  it,  and 
would  be  more,  if  there  were  no  such  place  as 
the  world.  Let  us  keep  our  pity  for  them  who 
have    retirement   thrust     upon    them.       Ill-health, 


RETIREMENT  135 

disablement,  bereavement,  misadventure,  offence, 
I  dare  not  write  of  these  ways  of  grief  and 
tragedy.  And  I  console  myself  with  the  thought 
that  a  man  may  have  retirement  thrust  upon  him, 
not  by  adversity,  but  by  prosperity.  A  legacy, 
too  big  to  be  hid,  from  a  kind  uncle,  the  sort  of 
legacy  that  gets  into  the  papers,  is  apt  to  make 
our  patients  say  that  we  do  not  want  practice, 
and  have  raised  our  fees  to  a  giddy  height,  and 
are  thinking  of  buying  a  palace  on  the  Grand 
Canal ;  and  as  for  his  wife,  my  dear  Louisa,  why, 
she  wont  look  at  you  and  me  now,  I  suppose.  In 
the  long  run,  the  uses  of  such  prosperity  may  be 
no  sweeter  than  the  uses  of  adversity. 

Of  them  who  achieve  retirement,  it  is  true  that 
we  may  all  do  that,  by  achieving  old  age :  we  have 
but  to  stay  here  till  practice  retires  from  us.  But 
I  would  narrow  the  phrase  and  keep  it  sacred. 
Achievement  is  a  word  for  Caesar.  He  achieves 
retirement,  whose  absence  is  felt  far  and  wide 
through  his  profession  ;  whose  work  stands  long 
after  he  has  gone.  He  led  and  taught  so  many  of 
us  :  he  set  so  many  of  us  on  lines  just  suited  to 
our  abilities,  he  knew  what  was  in  us.  To  watch 
him  operate,  was  a  pleasure :  to  meet  him  in  con- 
sultation, was  an  honour.  We  recall  his  very  words 
and  looks,  we  tell  old  stories  about  him  to  young 
men  who  will  never  see  or  hear  him. 

One  way    and   another,  we  retire.     What  next  ? 


136  CONFESSIO   MEDICI 

Fanciful  pictures  are  common,  too  common,  of 
Sabine  farms,  and  long  walks  and  long  talks,  and 
the  beauty  of  the  country.  These  pictures  are  not 
to  be  trusted.  Neither  in  the  country,  nor  in  the 
town,  is  it  easy  for  us  doctors  to  be  happy  in 
retirement.  For  consider  this,  which  I  reckon 
among  the  seeming  cruelties  of  Providence,  that  he 
who  has  done  most  suffers  most  from  the  want  of 
something  to  do;  he  who  has  worked  hardest  is 
hardest  hit  by  the  sudden  silence  of  the  loss  of 
work.  He  gave  up  everything  for  his  work,  and 
now  he  must  give  up  his  work.  Take  the  case  of 
Velox,  who  had,  as  we  all  know,  a  huge  practice 
in  the  Midlands.  By  day  and  night,  by  road  and 
rail,  he  drove  his  influence  to  every  point  of  the 
compass,  into  half-a-dozen  towns  and  fifty  villages  ; 
a  masterful  man,  dominant  and  positive,  a  born 
fighter,  loving  to  besiege,  in  all  honour  and  by 
declared  war,  the  strongholds  of  other  men.  For 
thirty  years  he  did  without  a  holiday,  never  afraid 
of  the  rush  of  the  day's  work,  the  night-calls,  the 
meals  got  anyhow,  the  nearness  of  a  breakdown  ; 
then,  victory,  and  a  stately  practice,  unassailable,  for- 
tified in  authority  :  at  last,  his  name  a  household 
word,  his  face  known  everywhere,  his  presence  felt, 
his  anger  dreaded,  his  verdict  final,  and  no  wonder, 
for  there  was  no  sounder  judge  of  an  obscure 
case,  not  in  all  England.  For  thirty  miles  round, 
he  was  the  man   to  have.      In  every  country-house. 


RETIREMENT 


37 


in  time  of  peril,  the  cry  was.  Send  for  Velox :  and 
he  knew  all  their  secrets,  and  very  unsavoury  some 
of  them  were.  See  him,  on  the  go  from  breakfast 
to  supper,  and  then,  after  supper,  over  his  pipe, 
writing  letters  and  making  up  his  books  to  any 
hour.     He   did  the  work  of  two  men ;  and  slept, 

like  Napoleon,  in  his  carriage.  

Then,  at  the  zenith  of  his  practice,  Velox  fell 
ill :  and,  with  a  certain  fitness,  his  malady  was  no 
less  tempestuous  than  himself  They  fought  it  out 
between  them :  Death  would  not  budge  an  inch  for 
Velox,  nor  he  for  Death.  Each  had  a  long  score 
against  the  other,  run-up  at  a  thousand  bedsides. 
The  struggle  was  of  unprecedented  length  and 
severity,  till  exhausted  Nature  finally  separated 
them,  and  declared  that  honour  was  satisfied.  The 
matter  was  compromised.  Velox  was  permitted  to 
survive,  to  Death's  disgust,  but  was  compelled  to 
retire,  to  Death's  relief.  They  exchanged  the  usual 
courtesies,  but  feebly,  for  both  of  them  were  badly 
shaken.  Death,  the  brute,  went  off  round  the 
corner,  and  avenged  himself  on  a  small  child,  one 
of  his  adversary's  patients.  Velox,  with  that  sen- 
tence ringing  in  his  ears,  stumbled  away,  somehow 
or  other,  out  of  the  crowd,  and  sat  down  to  think, 
like  Marius  among  the  ruins  of  Carthage.  The 
bitterness  of  retirement,  the  full  and  sudden  bitter- 
ness, had  come  to  him,  whose  life's  work  had  filled 
with  sweetness  so  many  lives.     He  was  not  thinking 


138  CONFESSIO   MEDICI 

of  the  loss  of  money.  At  seven  shillings  a  visit, 
and  even  at  less,  if  you  only  save  enough  lives, 
you  can  save  plenty  to  live  on.  He  was  thinking 
of  the  loss  of  work :  he  felt  as  if  he  were  bound 
hand  and  foot,  his  eyes  bandaged,  his  ears  stopped, 
his  mouth  gagged.  So  this  was  the  end  of  it  all, 
to  be  idle,  idle  :  to  come  to  a  standstill,  he,  Velox, 
to  be  superfluous,  to  have  nothing  to  do. 

We  told  him  that  he  would  enjoy  travelling, 
Italy,  Egypt,  a  voyage  round  the  world:  but  he 
did  not  want  to  see  the  world,  he  wanted  to  see 
patients.  Somebody  suggested  golf,  somebody 
bridge ;  and  he  turned  and  rent  them,  not  without 
bad  language.  Between  a  death  and  a  funeral,  you 
do  not  invite  the  chief  mourner,  by  way  of  con- 
solation, to  a  dinner-party  ;  and  Velox  had  just  lost 
the  love  of  a  life-time,  and  said  that  it  was  damned 
unkind  of  us  to  talk  rot  like  that  about  him  and 
bridge.  Books,  gardening,  politics,  were  all  urged, 
and  all  fell  flat :  or,  to  speak  with  exactness,  did 
not  fall,  having  nowhere  to  fall,  but  remained  in 
mid-air,  mere  possibilities,  waiting  till  Velox  should 
be  less  impossible.  Always,  he  had  been  proud  of 
having  no  time  for  these  pursuits,  proud  of  giving 
to  his  children  the  advantages  which  had  not  been 
given  to  him  when  he  was  their  age.  Two  sons 
at  the  University,  which  was  hard  indeed  to  man- 
age, and  four  daughters  as  well  educated  as  the 
county   families,    which    was    less   diflicult,  he  had 


RETIREMENT 


39 


spent  on  them  the  earnings  of  his  tearing  life. 
Touve  got  your  work  cut  out  for  you ^  he  used  to  say 
to  them,  and  your  Mother  has  got  her  s^  and  Tve  got 
mine.  Now,  it  is  cut  away  from  him.  What  shall 
take  its  place  ?  Shall  he  begin,  right  off,  at  sixty, 
to  enjoy  new  pursuits  ?  Cras  amet,  qui  nunquam 
amavit  ?  The  year  after  next,  perhaps,  he  may  be 
elected  Mayor:  a  fine  consolation,  when  a  man  is 
feeling  like  Prometheus  bound,  that  he  may  live  to 
be  a  Mayor. 

If  he  could  have  written  a  full  record  of  his 
experiences,  a  System  of  General  Practice,  it  would 
have  been  a  very  valuable  book.  But  the  greater 
part  of  his  wisdom  was  hardly  communicable ;  and 
he  had  mere  scraps  of  notes  of  cases,  and  not  one 
case  in  twenty  had  been  noted  at  sufficient  length  to 
be  of  any  use  for  a  book  :  and,  of  course,  it  had  not 
been  possible  for  him  to  keep  up  with  physiology 
and  bacteriology.  Besides,  the  whole  business  of 
writing  was  unfamiliar  to  him,  and  almost  ridiculous  : 
and  he  was  appalled  at  the  present  flood  of  medical 
literature,  especially  in  America  and  Germany.  No, 
catch  him  trying  to  write  a  book ;  men  must  find 
things  out  for  themselves,  by  experience,  the  way 
he  had  gone  :  and,  as  he  said  that,  it  sounded  like 
Pare's  voice.  See  how  I  learned  to  treat  gunshot  wounds; 
not  out  of  hooks. 

Prometheus  bound,  Samson  shorn  and  blinded, 
Velox  out  of  work,  are  tragic  figures :  but  most  of 


140  CONFESSIO   MEDICI 

us,  at  heart,  would  rather  be  cast  for  tragedy  than 
for  comedy.  It  is  better  to  be  dull  in  old  age,  than 
to  be  distracted,  in  middle  age,  by  outside  interests 
and  elaborate  devices  against  dullness,  such  as  men 
call  hobbies.  A  hobby  is  that  wooden  horse  through 
which  the  clown  in  the  circus  puts  his  legs,  and 
capers  round  the  ring  of  sawdust,  and  belabours  an 
opposite  clown  with  a  bladder  at  the  end  of  a  stick. 
It  is  true,  that  home,  friendship,  religion,  and  food, 
might  all  be  called,  in  relation  to  our  work,  outside 
interests  :  but  they  are  not  hobbies.  They  get 
inside  us,  and  urge  us  forward.  With  a  hobby, 
the  situation  is  reversed ;  we  get  inside  it,  and  urge 
it  forward.  That  is  a  hobby,  an  artificial  outside 
interest,  which  looks  as  if  it  were  sustaining  and 
impelling  us,  when  we  are  sustaining  and  impell- 
ing it. 

I  imagine  a  man  who,  at  forty-five,  having  before 
his  eyes  the  fear  of  an  aimless  retirement,  took,  for 
a  hobby,  the  modern  drama.  He  went  to  all  the 
new  plays  in  London,  talked  of  them,  wrote  of  them, 
and  signed  his  articles ;  he  even  ran  over  to  Paris  to 
see  plays  there :  at  last  he  wrote  a  play,  paid  for  its 
production,  and  it  was  fairly  successful.  By  the  time 
he  was  fifty,  he  was  full  of  theatrical  criticism ;  and 
people  who  were  well  said.  What  a  delightful  man  to 
sit  next ;  such  wide  interests  ;  I  dont  know  when  Tve 
enjoyed  a  dinner-party  more :  but  people  who  were  ill 
said,  Oh^  the  doctor  who  is  so  fond  of  Ibsen.     I  cannot 


RETIREMENT  141 

help  thinkings  as  my  case  is  such  a  peculiar  one,  I  would 
rather  have  somebody  else.  At  fifty-five,  he  had  written 
two  more  plays,  which  failed,  and  a  book,  profusely 
illustrated,  on  the  Modern  Drama  in  Germany ; 
having  unearthed  the  Beautiful  even  there.  He 
made  less  than  two  hundred  pounds,  that  year,  in 
practice.  At  sixty,  he  retired,  and  set  to  work  on 
a  Royal  Institution  lecture  on  the  Meaning  of 
Maeterlinck  ;  which  he  gave  ultimately  to  a  sub- 
urban literary  society.  In  retirement,  he  lost  heart, 
left  off  caring  about  plays,  came  to  himself  Medicine 
does  not  trouble  to  recover  her  prodigal  sons  :  once 
we  take  our  portion  and  go  into  a  far  country,  there 
we  stop  till  there  we  drop.  He  began  to  be  in  want, 
he  and  his  wife  and  the  children;  and  he  lived,  poor 
gentleman,  till  he  was  seventy-five. 

Velox,  also,  lived  longer  than  was  quite  agreeable 
to  him  :  but  was  comforted,  always,  by  the  thought 
that  he  had  done  everything  for  the  best,  had  worked 
hard  and  close,  lost  no  opportunity,  never  swerved 
from  his  purpose.  He  mourned  the  death  of  his 
work  ;  but  rejoiced,  that  his  work  and  he  had  never, 
all  those  many  years,  been  apart,  never  at  variance. 
He  had  loved,  cherished,  and  honoured  his  work  ; 
sentences  of  the  marriage-service,  he  often  used  to 
say,  ran  in  his  head  —  With  my  body  I  thee  worship  ; 
I  take  thee  only  unto  me  —  Never  a  cross  word,  for 
near  forty  years,  between  him  and  his  work  :  he  con- 
soled himself  with  that  precious  memory.     Every 


142  CONFESSIO   MEDICI 

doctor,  sooner  or  later,  must  lay  his  practice  in  her 
grave.  He  who  has  not  loved  her,  will  soon  see  her 
buried,  and  will  hardly  be  sorry  :  and  the  general  air 
of  her  obsequies  will  be  that  of  Gounod's  Funeral 
March  of  a  Marionette.  But  Velox,  at  the  burial 
of  his  love,  was  crying,  yet  a  grand  figure  ;  and 
the  whole  place  was  black  with  mourning,  and  a 
hundred  kind  hearts  put  up  the  shutters  of  respect 
and  pity. 

By  and  by,  he  began  to  find  contentment  in  odd 
nooks  and  corners  of  life,  which  from  want  of  time 
he  had  left  unexplored  :  found  what  a  host  of  friends 
he  had,  and  what  wonderful  grandchildren,  and  how 
casual  and  off-hand  had  been  his  estimates  of  other 
men's  words  and  deeds.  Of  course,  he  had  his  bad 
times  of  dullness  and  loneliness.  Especially,  at  those 
hours  of  the  day  which  were  most  unkind,  he  must 
sit  and  hear  the  devil  saying.  Nobody  wants  you  now. 
That  was  horrible,  the  sense  that  he  was  inventing 
engagements,  protracting  occupations,  playing  at 
work ;  that  his  colleagues  had  put  him  on  the 
Board  of  the  Hospital  to  give  him  something  to 
do  and  keep  him  from  moping  ;  that  an  old  patient, 
now  and  again,  would  consult  him  as  it  were  out  of 
charity.  Or  he  would  be  cut  by  the  sense  of  the 
finality  of  his  loss,  or  by  its  cruelty,  its  waste  of  all 
his  experience  ;  or  would  be  worrying  himself  that 
another  man  was  attending  Mrs.  So-and-so,  and  did 
not  know  the  ins  and  the  outs  of  her  case.     Oh,  he. 


RETIREMENT  143 

had  his  bad  times,  he  suffered.     He  took  up  no  new 
pursuit  of  any  importance ;  there  was  none  that  he 
cared  to  take.     He  found  no  rapture  in  the  con- 
templation of  the  country,  or  in  the  destruction  of   h, 
lower  forms  of  life  :   no  bliss  in  organized  philan-  ' 
thropy,  and  no  allurement  in  poetry.     To  the  end 
of  his  days,  he  remained  shy  of  Nature,  bored  by 
solitude,  and  averse  from  the  artistic  temperament. 
Long  ago,  like  the  rulers  of  Plato's  Republic,  he  ^ 
had  turned  the  poets  and  the  musicians  out  of  the 
kingdom  of  his  life,  and  was  not  minded  now  to 
recall  them  :  besides,  if  he  had,  they  would  not  have    1 
come. 

But  Heaven  gave  him,  thus  disabled  in  its  service, 
a  handsome  pension.  Great  respect  is  paid,  by 
Heaven,  to  the  Employers*  Liability  Act ;  and  it 
accepts  the  extension  of  that  Act  even  to  those 
whom  it  employs  only  for  odd  jobs  at  infrequent 
intervals  :  but  Velox,  of  course,  had  been  in  regular 
employment.  It  is  not  in  a  hurry  to  pay  all  claims: 
indeed,  some  people  are  of  opinion  that  application 
must  be  made  in  person.  Anyhow,  Velox  got  his 
pension,  paid  in  every  coin  of  that  realm  :  but  I  am 
not  speaking  from  experience  of  such  transactions. 
I  only  know  that  he  was  paid,  in  peace  of  mind,  in 
a  clear  conscience,  in  home-love,  in  a  name  honoured 
far  and  wide,  in  faith  and  hope,  and  in  shrewd  and 
mellow  wisdom.  For  the  sake  of  his  work,  he  had 
lived  in   a  groove,  in   a   narrow  sort  of  way ;   and 


144  CONFESSIO   MEDICI 

behold,  now  that  he  was  permanently  out  of  work, 
he  had  the  reward  of  that  way. 

Back  we  come  to  the  meaning  of  the  word 
Retirement,  and  to  my  threefold  vision  of  the 
soldier,  the  amoeba,  and  the  hermit.  He  who  dares 
not  be  narrow  when  he  is  young,  from  fear  he 
shall  be  dull  in  old  age,  is  the  amoeba :  when  he 
retires,  he  stops.  Velox,  in  his  retirement,  attained 
something  of  the  courage  of  a  soldier,  the  patience 
of  a  saint.  And  he  had  need  of  these  graces. 
Here,  at  last,  thinking  of  him,  I  find  one  more 
figure  of  retirement.  It  is  our  school.  It  pre- 
pares us,  none  too  pleasantly,  to  go  up  to  the 
University  of  Old  Age,  that  grim  seat  of  desperate 
learning,  where  we  finish  our  education,  and  take 
our  degree. 


THE  VERY   END 

By  the  time  that  they  come  to  the  sea,  all  great 
rivers  are  much  alike.  Their  surroundings  are 
blank  and  flat,  no  longer  the  hills  and  the  woods, 
and  not  yet  the  cliffs.  Their  waters,  no  longer 
sweet,  and  not  yet  salt,  have  lost  force,  and  are 
swayed  by  the  tides.  All  depth  of  colour,  sharp- 
ness of  outline,  and  strength  of  purpose,  are  gone 
from  rivers  thus  dying ;  neither  the  sea,  nor  the 
land,  seems  to  want  them,  and  they  are  neither  at 
work  nor  at  rest.  No  more  adventures  for  a  river 
so  near  its  end,  no  surprises  in  store  for  it,  no 
hope  of  further  increase.  It  has  taken  its  last 
tribute  from  the  hills,  and  has  said  goodbye  to 
them ;  has  given  its  blessing  to  its  towns,  and 
forgiven  them  their  sins,  their  poisonous  factories  : 
has  closed  its  account  with  earth.  One  or  two 
ships,  by  way  of  trade,  still  find  some  hope  of 
profit  in  this  desolate  stretch  of  the  river's  course, 
and  come,  and  hang  about,  like  distant  relatives 
waiting  on  the  mere  chance  of  a  legacy  :  but  the 
river    hardly    recognizes    them.       Besides,    it    has 


146  CONFESSIO   MEDICI 

nothing  now  that  it  can  call  its  own.  Long  ago, 
it  made  its  will,  disposed  of  its  property,  gave 
everything  to  the  children.  It  cannot  even  re- 
member now  what  it  did  with  its  wealth ;  or  it 
would  have  a  thousand  pleasant  memories  of  gifts 
to  every  city  and  every  field,  right  and  left,  all  the 
way :  but  its  mind  is  clouded  and  confused,  for 
it  is  within  a  mile  or  two  of  its  dissolution. 
Silent,  lonely,  passive,  moving  not  of  itself  but  of 
the  tides,  it  becomes,  hour  by  hour,  less  river  and 
more  sea ;  and  dies,  by  inches,  in  its  sleep. 

Not  all  rivers  end  like  that.  Some  run  full  tilt, 
laughing  and  shouting  Here  goes,  and  are  gone ; 
some  leap  from  a  height,  and  put  an  end  to  them- 
selves, as  if  they  had  lost  their  senses  ;  some  just 
shuffle  into  the  sea,  in  a  slipshod  fashion,  as  if 
they  did  not  know  that  it  was  there ;  and  some, 
fighting  to  the  last  moment,  retain  for  a  while, 
even  among  the  waves,  their  colour  and  their 
outline.  But  these  are  the  lesser  rivers,  that  die 
young.  There  is  something,  but  not  much,  to  be 
said  in  praise  of  dying  young.  Is  there  not  something 
brave  and  spirited,  says  Stevenson,  /';;  such  a  termina- 
tion ?  and  does  not  life  go  down  with  a  better  grace, 
foaming  in  full  body  over  a  precipice,  than  miserably 
straggling  to  an  end  in  sandy  deltas  ?  And  that  Greek 
poet,  who  says  that  they  whom  the  Gods  love, 
die  young,  does  not  mean  that  they  whom  the 
Gods  love,  may  live  to  be  old,  yet  will  always  be 


THE   VERY  END  147 

young :  he  means  what  he  says.  But  what  is 
the  good  of  all  this  talk  about  the  Gods,  and 
bravery,  and  grace  ?  Length  of  days  is  not  a 
matter  of  choice.  A  river  cannot  end,  with  a 
plunge  and  a  flourish,  just  when  and  where  it 
Hkes  :  and  a  great,  laborious  river,  many  hundreds 
of  miles  old,  is  bound  to  have  a  lingering,  mono- 
tonous time,  on  its  way  out. 

Matthew  Arnold,  in  Sohrab  and  Rustum^  attributes 
a  happier  disposition  to  the  Oxus.  It  moved  re- 
joicing, he  says,  toward  the  sea,  as  toward  home, 
longing  to  hear  the  dash  of  the  waves.  His 
narrative  poems  are  none  too  light-hearted  ;  and  I 
cannot  say  how  it  may  be  with  the  Oxus,  for  I  do 
not  know  that  river,  not  even  on  the  map.  But 
the  more  common  destiny  of  great  rivers,  at  the 
very  departure  of  life,  is  to  be  kept  waiting,  without 
rejoicing. 

The  reason  why  the  river  miserably  straggles  to 
an  end  in  sandy  deltas,  is  in  the  river  itself  All 
the  way,  it  has  been  bringing  down  tons  of  alluvial 
soil.  By  its  own  doing,  it  has  prepared  for  itself 
a  slow  and  difficult  exit :  the  very  length  and 
breadth  of  its  course  have  created  these  impeding 
deltas.  Ever  since  it  was  born,  it  has  been  deciding 
how  it  will  die  ;  and  cannot  now  go  back  on  that 
decision. 

Its  dreams,  as  it  falls  asleep,  are  haunted  by 
signals  of  coming  change.     Nothing  happens ;  but 


148  CONFESSIO   MEDICI 

something,  it  is  sure,  is  going  to  happen.  The 
tides,  it  says,  must  mean  something ;  so  must  the 
brackish  taste  of  its  waters,  and  the  unfamihar  flakes 
of  weed  in  them,  and  the  appearance  and  disappear- 
ance of  httle  islands,  where  strange  birds  wheel 
and  light,  and  stay  a  minute,  and  are  off  again. 
Oh,  there  cannot  be  a  doubt  of  it,  with  all  these 
signallings  and  premonitions,  something  is  certainly 
going  to  happen.  Meanwhile,  how  slow  it  all  is, 
this  featureless,  drifting,  last  bit  of  existence,  neither 
one  thing  nor  the  other,  neither  here  nor  there. 

So  unkind  may  be  the  extremity  of  our  old  age. 
Take  the  case  of  that  famous  old  servant  of  God, 
let  us  call  him  Prudens,  the  eminent  surgeon. 
Consider  what  influence  he  had  on  the  men  and 
women  of  his  time,  and  how  his  work  enriched 
the  fields  of  science  and  practice.  All  his  life,  he 
was  learning  and  teaching :  he  ':gave  back  to  man- 
kind what  he  got  from  mankind,  he  turned  the 
waste-products  of  disease  to  the  uses  of  health. 
But,  do  what  he  would,  he  could  not  give  away 
all  that  he  amassed  ;  and  he  brought  down,  to  the 
coast-line  of  his  life,  great  stores  of  alluvial  know- 
ledge. Now,  he  was  told.  Stay  where  you  are. 
Nature  showed  him,  at  the  last,  no  gratitude,  no 
reverence,  and,  I  would  add,  no  mercy.  She  kept 
him  waiting.  He  could  neither  enjoy,  nor  impart, 
his  accumulated  experiences  :  they  lay  in  his  mind, 
at   last,  as    the  deltas   lie   at   the   last  of  old    Nile, 


THE  VERY  END  149 

and  he  seemed  to  be  trying  to  find  his  way  out, 
among  so  many  results,  without  strength  to  get 
past  them.  Science  was  become  impossible,  practice 
had  long  ago  vanished ;  and  even  friendship  was 
mostly  a  memory,  for  he  could  not  see  more  than 
one  or  two  friends.  Work  was  at  an  end,  and  so 
were  hoHdays.  The  sixteen-hours'  day,  the  pride 
of  overwork,  had  been  his  Hfe.  Visits  and  con- 
sultations and  country  journeys.  Hospital  practice 
and  lectures,  solemn  committees.  Royal  Commissions, 
learned  Societies,  Councils  and  Congresses,  and  four 
or  five  hours  of  reading  and  writing  after  dinner, 
had  been  the  material  out  of  which  he  had  still 
made  time  for  religion,  home,  and  society.  He 
had,  really,  made  Time :  which  is  a  most  divine 
achievement.  Now,  it  was  all  Time,  and  none  of 
it  of  his  making.  He  must  be  helpless,  unable 
to  walk,  or  to  speak  above  a  whisper,  or  to  perform 
without  distress  the  meanest  functions  of  his  body, 
or  to  put  himself  to  bed.  Prudens,  ok  yes,  he  is  alive, 
hut  very  infirm:  but  he  must  be  alive,  or  we  should 
have  heard  of  it.  That  was  now  become  his  life, 
to  go  on  being  very  infirm. 

But  Prudens,  at  the  heart  of  his  infirmities,  was 
still  Prudens ;  and  faced  the  situation  with  that 
gravity,  reticence,  and  authority  which  had  always 
distinguished  him  in  practice.  Here  was  the  last 
case  that  he  would  ever  have,  himself,  a  typical  case 
of  natural  decay.     Not  a  very  interesting  case,  but. 


150  CONFESSIO   MEDICI 

take  it  or  leave  it,  he  would  never  have  another: 
and  some  of  its  aspects  appealed  to  him.  For  he 
had  always  been  skilled  in  advising  how  lives  which 
were  past  cure  might  yet  be  rendered  valuable,  and 
how  they  who  would  never  be  themselves  again 
must  adjust  themselves  to  that  loss.  This  last 
patient,  himself,  this  foregone  conclusion,  this  forlorn 
hope,  would  anyhow  give  him  an  opportunity  to 
exercise  judgment,  and  to  make  deliberate  choice 
of  a  method  of  treatment. 

Of  course,  he  began  the  treatment  in  the  first 
stage  of  the  malady.  There  are  two  ways,  and 
no  more,  of  treating  natural  decay.  You  begin 
with  active  resistance :  in  the  final  stage,  you  have 
recourse  to  passive  resistance.  So  long  as  he  was 
capable  of  action,  he  clung  to  the  remnant  of  his 
work ;  cherished  every  engagement  that  was  still 
within  his  power,  refused  help,  fasted  from  ease,  and 
urged  his  tired  limbs  to  be  always  at  some  employ- 
ment. In  brief,  he  went  on  doing  all  that  he  could 
do.  Then,  when  active  resistance  was  overborne 
and  impossible,  came  the  time  of  passive  resistance. 
He  made  no  protest ;  he  was  silent :  you  cannot 
imagine  him  playing  to  the  gallery.  He  simply 
went  on  being  all  that  he  could  be.  In  politics, 
the  passive  resister's  goods  are  seized  once  a  year : 
but  Prudens  suffered  distraint  daily,  and  that  not 
on  his  goods  but  on  himself  Impending  Death 
had,  as  it  were,  put  the  bailiffs  into  the  house  of 


THE   VERY  END  151 

his  soul ;  Very  well^  said  he,  they  can  take  what 
they  like:  and  they  did.  They  took  his  strength, 
his  memory  of  names  and  faces,  the  sharpness  of 
his  senses,  the  use  of  his  hands.  Always,  he 
managed  somehow,  by  sleep,  by  force  of  will,  by 
sheer  grace,  to  repair,  or  almost  to  repair,  the  levy 
of  the  day  before.  There  was  always  something 
still  to  be  taken.  He  went  without  ceasing,  and 
nobody  bought  him  back ;  yet  there  he  was,  daily, 
much  the  same,  to  the  very  end,  when  there  came 
a  touch  of  pneumonia,  which  doctors  call  the  old 
man's  friend,  and  Death  was  left  in  possession. 

The  spirit  of  practice  is  positive  that  there 
was  nothing  to  be  seen  but  the  multiplication  of 
infirmities,  the  closing  of  the  avenues  of  sense,  the 
decay  of  the  whole  fabric.  Neither  in  the  last  few 
months,  nor  in  the  last  few  days,  was  there  any 
sudden  light  or  heat  from  the  embers  of  his  life : 
they  steadily  cooled,  and  fell  into  ashes.  Nothing 
happened ;  only,  everything  went.  When  every- 
thing had  gone,  he  went.  Somewhere  in  the  brain, 
like  one  lamp  not  turned-out  in  an  empty  theatre, 
a  little  group  of  cells,  for  a  few  hours,  did  just 
complete  the  circuit ;  and  then,  not  even  that.  But 
suppose  that  Prudens  had  been  conscious  up  to  the 
last  moment,  like  that  other  eminent  surgeon,  who 
put  his  finger  to  his  pulse,  and  waited  till  the  instant 
came,  and  said  Stopped,  and  died ;  yet  here  is 
nothing  beyond  ordinary  facts. 


152  CONFESSIO   MEDICI 

Doctors,  of  course,  have  no  special  information 
here.  We  are  as  much  in  the  dark,  here,  as 
everybody  else.  The  spirit  of  practice  bids  us  think 
of  faith  and  hope  as  open  questions,  and  confine 
our  attention  to  charity :  and,  so  far  as  the  latter 
part  of  this  injunction  goes,  we  do  not  need  much 
bidding. 

Still,  we  have  our  private  opinions.  I  am  re- 
minded, here,  of  one  of  my  friends,  who  is  of 
opinion  that  we  should  no  more  look  to  Nature 
for  hope  than  to  miracles  for  faith.  He  does  not 
believe  in  miracles :  and  he  finds  no  evidence  in 
Nature  of  any  order  but  that  of  Nature.  Indeed, 
his  professional  familiarity  with  her  senseless  failures 
and  useless  cruelties,  if  that  were  all,  would  make 
him  deny  the  possibility  of  any  other  order.  But, 
well  away  from  his  work,  he  is  just  able,  he  tells 
me,  with  some  trouble  —  and  most  things  worth 
doing  are  troublesome  —  to  find  and  hold,  now  and 
again,  the  belief  that  he,  and  not  his  brain,  is 
conscious.  He  had  the  toothache  lately,  and  de- 
clared to  me  that,  according  to  his  philosophy,  he 
had  the  toothache,  but,  according  to  Haeckel,  he 
was  the  toothache,  or  would  be  the  toothache,  if 
he  were  he,  which,  according  to  Haeckel,  he  could 
never  hope  to  be,  or  be  to  hope.  He  added,  that 
It  was  he  who  experienced  the  tooth  in  space,  and 
the  ache  in  time,  and  united  these  two  dissimilar 
experiences,    in    his    permanent    identity,    as    the 


THE   VERY   END  153 

toothache.  I  will  not  pretend,  for  it  was  a  very 
bad  tooth,  that  all  his  language  was  so  philosophical. 
Anyhow,  he  was  sure  that  we  cannot  be  what  we 
have,  or  have  what  we  are. 

But  the  toothache,  after  all,  is  not  the  sort  of 
malady  to  shake  a  man's  belief.  What  does  that, 
is  the  dismal  acquaintance  of  us  doctors  with  brains 
injured,  diseased,  ill-developed,  ill-nourished,  wasted 
by  drink,  poisoned  slowly  by  toxins,  or  suddenly 
held-up  by  an  anaesthetic.  These  and  the  like  facts 
are  apt  to  haunt  us,  when  we  get  home  after  the 
day's  work.  The  doctor,  let  us  say,  has  just  been 
seeing  a  case  of  concussion.  Back  at  home,  he 
cannot  doubt  that  his  wife  and  the  children,  in 
the  same  circumstances,  would  present  the  same 
aspect  as  the  patient ;  and  the  sudden  thought 
runs  into  him  like  a  pin,  that  he,  and  she,  and  all 
of  them,  especially  the  baby,  are  but  organisms ;  to 
say  nothing  of  the  dog  on  the  hearth-rug.  For  a 
moment,  things  look  black :  the  home-talk  flags, 
he  is  silent,  addressing  himself  to  that  plateful  of 
food  which  is  on  its  way  from  being  his  to  being 
he.  The  general  impression,  round  about  the 
table,  is  that  Father  is  very  tired ;  give  him  his 
pipe,  and  his  slippers,  and  the  evening  paper : 
perhaps  something  has  disagreed  with  him.  In- 
deed, something  has.  That  ugly  log  of  a  body,  miles 
away,  has  disagreed  with  his  faith. 

Consider,  again,  the  case  of  Prudens.     The  spirit 


154  CONFESSIO   MEDICI 

of  practice  was  quite  certain  that  he  came  to  an 
absolute  end.  He  had  been  he,  and  was  become  it. 
Like  Michael  and  Satan  in  the  legend,  fighting 
over  the  body  of  Moses,  so  these  two  words. 
He  and  It,  fought  over  the  body  of  Prudens. 

The  river,  to  which  I  compared  the  course  of 
Prudens'  life,  died,  like  him,  by  inches ;  without 
assurance  of  revisiting  or  remembering  the  land,  or 
of  retaining,  in  the  sea,  its  limiting  banks.  Only,  it 
felt  sure  that  something  was  going  to  happen,  and 
that  the  tides  were  not  there  for  nothing.  It  was 
to  suffer  a  sea-change,  it  felt  sure  of  that,  but 
was  unable  to  think  further.  So,  with  Prudens, 
as  we  watched  him,  we  felt  sure  that  something 
was  going  to  happen  :  but  what  it  would  be,  and 
how  he  could  still  be  he  through  it,  we  could  not 
say.  But  rivers  go  out  as  candles  go  out.  Their 
dissolution  is  a  purely  chemical  process  :  they  have 
no  identity  but  in  us.  The  death  of  Prudens,  his 
dissolution,  was  also  chemical,  to  all  appearances : 
but  we  knew  that  his  life  had  not  been  a  matter 
of  chemistry.  So  it  seemed  reasonable,  to  trust 
our  memory  of  him,  and  to  believe  that  he  died  as 
he  had  lived,  at  another  level  than  that  of  the  natural 
sciences.  It  was  hard  to  see  how  he  should  still 
be  individual  and  distinct :  but  we  were  sure  that 
the  individuality,  which  had  distinguished  him 
here,  had  been  real.  Once,  he  had  been :  some- 
how, therefore,  he  is :  that  was  the  argument.     He 


THE  VERY  END  155 

had  been  he:  and,  though  words  are  useless  here, 
the  fact  remains,  that  nobody  has  any  right  to 
play  conjuring-tricks  with  the  two  most  difficult 
words  in  our  language,  which  are  He  and  It. 
Prudens,  not  it  but  he,  still  he,  went  to  what  had 
been,  always,  the  spiritual  element  of  his  Hfe. 
The  reality  of  that  element,  and  the  reality  of 
him,  part  of  it  yet  apart  from  it,  are  facts  which 
he  had  so  proved  by  the  manner  of  his  life  that 
they  were  not  challenged  by  the  manner  of  his 
death. 


EPILOGUE 

It  is  the  plain  duty  of  us  doctors,  who  are  Life's 
paying  guests,  to  be  thankful  for  what  we  have 
received.  A  man  is  not  likely  to  find  it  hard  to 
be  thankful,  if  only  he  will  begin  low  enough  down ; 
he  should  approve  the  order  of  Life,  as  Lord  Mel- 
bourne approved  the  order  of  the  Garter :  and,  if 
he  would  be  profoundly  thankful,  he  must  begin 
de  profundis.  Instances  are  recorded  of  people 
giving  thanks  before  taking  physic ;  not  from  any 
fear  of  the  consequences,  but  with  gladness  antici- 
pating them.  It  is  not  all  of  us  who  could  be  so 
good  as  that ;  but  we  might  be  more  thankful  for 
not  having  either  to  take  physic  or  to  submit  to 
surgery,  seeing  how  many  thousands  of  invalids  are 
passionately  longing  to  be  able  to  do  without  pain 
what  we  do  without  pleasure.  Once  a  man  were 
to  particularize  all  the  bodily  acts  which  are  health, 
he  would  be  long  over  that  list,  and  would  include 
many  advantages  which  the  polite  world  does  not 
name  in  general  conversation.  For  our  food,  it 
should  be  easy  to  be  thankful ;  and  so  we  are,  when 

156 


EPILOGUE  157 

we  are  hungry  :  but  the  doctor  is  not  fond  of  the 
use  of  grace  before  a  big  dinner.  He  knows  too 
much,  he  foresees  in  the  mind's  eye  the  course  of 
each  course,  he  cannot  pray  over  proteids  and  carbo- 
hydrates, and  them  in  excess. 

Advancing  outside  our  bodies,  we  come  to  the 
question  whether  we  need  be  thankful  that  we  are 
so  useful.  It  is  not  easy,  because  all  of  us  are 
useful,  and  the  supply  of  us  exceeds  the  demand. 
But  what  of  that  ?  A  man's  use  is  what  it  is, 
though  his  work,  if  he  should  leave  it,  would  in  a 
few  days  be  in  hands  no  less  able.  The  work  is 
the  man  :  it  is  not  the  work  that  counts,  but  the 
man  at  work.  Here,  at  this  level  of  thought, 
reasons  for  thankfulness  extend  all  round  us  like  a 
landscape  :  the  help  that  we  give,  the  lives  that  we 
save  or  prolong,  the  friendships  that  we  make  and 
keep  to  the  end. 

I  have  had  losses :  and  my  heart  goes  out  to 
Dogberry,  for  he  reckons  his  losses  among  his 
accomplishments.  "  I  am  a  wise  fellow  ;  and,  which 
is  more,  an  officer ;  and,  which  is  more,  a  house- 
holder ;  and,  which  is  more,  as  pretty  a  piece  of 
flesh  as  any  in  Messina;  and  one  that  knows  the 
law,  go  to  :  and  a  rich  fellow  enough,  go  to  ;  and 
a  fellow  that  hath  had  losses ;  and  one  that  hath 
two  gowns,  and  everything  handsome  about  him." 
They  who  have  had  losses  are  good  company,  and 
I  am  glad  to  be  of  their  fellowship.     A  man  would 


158  CONFESSIO   MEDICI 

like  to  possess  this,  that,  and  the  other  ;  but  they 
who  do  without  these  luxuries  may  be  as  happy  as 
they  who  have  them.  He  would  like  to  save  the 
lives  of  Dukes  ;  but  the  tissues  of  humbler  folk 
are  just  as  interesting.  He  would  like  to  be 
immensely  proud  of  his  own  performances,  all  of 
them ;  but  who  is,  except  a  thrice-distilled  fool  ? 
He  would  like  to  leave  more  money  behind  him  — 
ah,  that  regret  is  sacred,  and  must  not  be  profaned ; 
but  things  may  mend.  He  has  not  fulfilled  his 
ambition  to  be  at  the  top  of  the  tree ;  but  he  can 
still  congratulate  himself  that  he  is  on  a  branch. 
The  natural  dignity  of  our  work,  its  unembarrassed 
kindness,  its  insight  into  life,  its  hold  on  science  — 
for  these  privileges,  and  for  all  that  they  bring  with 
them,  up  and  up,  high  over  the  top  of  the  tree,  the 
very  heavens  open,  preaching  thankfulness.  Circle 
above  circle,  the  reasons  for  it  are  established,  out 
of  the  reach  of  words. 


THE   MACMILLAN   COMPANY 

publishes  a  very  large  number  of  books  containing  a  great 
variety  of  essays  covering  a  wide  range  of  subjects.  Among 
such  may  be  named  many  delightful  books  by  well-known 
authors. 

By  CARL   HILTY 

Professor  of  Constitutional  Law,  University  of  Bern,  Switzerland 

Happiness 

Translated  by  the  Rev.  Francis  G.  Peabody, 
Plummer  Professor  of  Christian  Morals  in  Harvard  University 

Clothy  i2mo,  $1.25  net;  by  mail,  $1.35 

The  character  of  this  series  of  ethical  essays  is  indicated  by  the  follow- 
ing list  of  topics :  The  Art  of  Work,  How  to  Fight  the  Battles  of  Life, 
Good  Habits,  The  Children  of  This  World  Are  Wiser  Than  the  Children 
of  Light,  The  Art  of  Having  Time,  Happiness,  The  Meaning  of  Life. 

The  New  York  Times  voiced  the  sentiments  of  all  readers  in  the  fol- 
lowing comment :  "  The  author  makes  his  appeal,  not  to  discussion,  but 
to  life ;  .  .  .  that  which  draws  readers  to  the  Bern  professor  is  his  ca- 
pacity to  maintain,  in  the  midst  of  important  duties  of  public  service  and 
scientific  activity,  an  unusual  detachment  of  desire  and  an  interior  quiet- 
ness of  mind." 

The  Steps  of  Life 

Further  Essays  on  Happiness 

Translated  by  Melvin  Brandow,  with  an  Introduction 
by  Francis  G.  Peabody 

Cloth,  izmo,  $i.2j  net;  by  mail,  $1.35 

Professor  Hilty's  uplifting  Essays  long  ago  took  rank  in  Germany  as 
classics  in  their  sphere  —  that  of  personal  culture  in  ethics  and  religion ; 
and  have  had  an  enormous  sale  and  wide  distribution. 

The  reason  is  plain.  At  rare  intervals  a  man  will  appear  to  whom  it 
is  given  to  see  more  deeply  into  hfe  than  his  fellows.  Such  a  man  Carl 
Hilty  seems  to  be. 


By  FREDERIC   HARRISON 

The  Choice  of  Books 

In  Macmillan's  Miniature  Series 
Cloth  J  gilt  top,  i6mo,  boxed,  $i.oo  net 

"Those  who  are  curious  as  to  what  they  should  read  in  the  region  of 
pure  literature  will  do  well  to  peruse  my  friend  Frederic  Harrison's  vol- 
ume called  'The  Choice  of  Books.'  You  will  find  there  as  much  wise 
thought,  eloquently  and  brilliantly  put,  as  in  any  volume  of  its  size."  — 
Mr.  John  Morley. 

The  Meaning  of  History  and 

Other  Historical  Essays 

Cloth,  crown  8vo,  $1.75 

"  Mr.  Harrison's  abilities  as  an  historical  writer  are  fully  recognized  by 
many  who  do  not  at  all  agree  with  the  philosophical  views  of  which  he  is 
so  earnest  an  advocate;  and  they  might  wish  that  he  had  given  us  more 
books  like  the  present.  There  are  no  better  specimens  of  popular  work, 
in  a  good  sense  of  the  word,  than  are  to  be  found  in  several  of  these 
pieces."  —  The  Academy,  London. 

Memories  and  Thoughts 

Cloth,  crown  8vo,  410  pp.,  gilt  top,  $2.00  net 

"The  personal  note  is  dominant  throughout  Mr.  Harrison's  book,  which 
leaves  us  with  a  sense  of  friendly  and  close  acquaintance  with  a  writer  in 
whom  seriousness  of  purpose,  firm  convictions,  broad  culture,  and  gen- 
erous sympathies  combine  with  the  thinker's  love  of  truth,  the  artist's  love 
of  beauty,  and  a  keen  zest  for  the  joys  of  living.  And  now  and  again,  in 
the  informality  of  his  manner,  he  gives  rein  to  a  whimsicality,  a  wilfulness, 
a  petulance,  or  an  extravagance  that  lend  to  his  style  a  pungent  tang  or  a 
pleasing  piquancy.  .  .  .  'Memories  and  Thoughts' is  a  book  to  read  and 
read  again,  compact  of  good  matter  well  indited."  —  The  Outlook. 

"  It  is  not  too  high  praise  to  set  this  among  the  most  interesting  and  the 
most  valuable  books  of  the  last  decade.  It  is  of  course  written  in  exqui- 
site style  and  finish,  with  every  charm  of  literary  allusion  and  irradiated 
with  the  marvellous  wealth  of  knowledge  and  thought  of  the  author;  but 
it  is  something  more  and  better  than  this.  It  is  one  of  the  most  illuminat- 
ing commentaries  upon  the  life  and  thought  of  England  within  the  seventy 
years  it  covers  that  have  been  or  ever  will  be  published."  —  Columbia 
StaU. 


By  THOMAS   R.    SLICER 

The  Way  to  Happiness 

Cloth y  I2m0f  gilt  top,  $1.25  net 

Dr.  Slicer  approaches  the  subject  from  the  standpoint  of  a  profound 
lover  of  his  fellow-man  and  a  keen  observer  of  his  deeper  needs.  In  the 
midst  of  a  life  vi^hose  activities  reach  out  into  many  phases  of  our  complex 
civilization,  he  pauses  to  sound  this  clear  call  to  happiness  and  to  urge 
upon  his  readers  that  happiness  is  not  only  a  duty,  but  a  necessity  ;  that 
it  is  not  some  far-off  mystical  Holy  Grail  for  which  we  are  in  search,  but 
the  Joy  of  Life ;  that  happiness  is  natural  and  of  the  very  essence  of 
things,  and  that  in  proportion  as  we  cease  to  be  natural  we  cease  to  be 
happy ;  that  the  "  search  for  happiness  is  the  effort  to  secure  a  self- 
lubricating  human  life." 

By  SIMON  N.   PATTEN 

The  New  Basis  of  Civilization 

Cloth,  i2mo,  $1.00  net;  by  mail,  $1.10 

"  His  analyses  of  the  changing  ideas  about  charity,  sacrifice,  and  compe- 
tition are  accurate  and  sometimes  profound.  Professor  Patten  is  here  the 
spokesman  for  the  ever  growing  body  of  social  workers  who  are  strug- 
gling to  bring  about  the  new  civilization  by  using  in  a  wiser  way  the 
energies  that  make  the  philanthropies,  the  labor  organizations,  the  social 
settlements,  the  churches,  and  the  theatres."  —  A^ew  York  Tribune, 

By  NICHOLAS  MURRAY   BUTLER 

President  of  Coluj?ibia  University 

True  and  False  Democracy 

Cloth,  i2mo,  $1.00  net;  by  mail,  $1.10 

**  If  legislators,  teachers,  labor  unionists,  millionaires,  and  everybody  else 
would  read  and  ponder  this  book,  our  country  would  be  much  better  off 
than  it  is.  .  .  .  The  whole  fallacy  of  Socialism  is  exposed  here  in  a 
few  pages.  The  work  is  kindly  and  sympathetically,  but  none  the  less 
thoroughly,  done." 


By  ARTHUR   TWINING   HADLEY 

President  of  Yale  University 

Standards  of  Public  Morality 

Cloth,  i2mo,  $1.00  net;  by  mail,  $i.io 

"  Perhaps  the  most  satisfactory  explanation  of  the  incongruous  differ- 
ence between  American  standards  of  public  and  private  morality  yet  given 
in  popular  form  is  set  forth  in  the  first  essay."  —  New  York  Tribune. 

"  The  volume  is  all  the  better  for  its  exactly  aimed  point  and  concise- 
ness." —  Chicago  Tribune. 

By  HAMILTON   W.   MABIE 
Backgrounds  of  Literature 

"  A  collection  of  papers  in  which  Wordsworth,  Emerson,  Irving,  Goethe, 
Blackmore,  Whitman,  Scott,  and  Hawthorne  are  treated  with  reference  to 
the  scenes  in  which  they  labored  and  by  which  they  were  influenced. 
There  is  some  illuminating  work  in  this  book,  sagacious  interpretation  of 
literary  personalities.  The  illustrations  are  half-tones  from  photographs 
of  landscape  and  architecture."  —  New  York  Tribune. 

Cloth,  J02  pp.,  Illus.,  in  a  box,  $2.00  net 
(postage  15c.) 

Parables  of  Life 

"They  touch  with  a  loving  and  reverent  hand  the  inmost  experiences 
of  personal  life.  .  .  .  Poetic  in  conception,  vivid  and  true  in  imagery, 
delicately  clear  and  pure  in  diction,  these  little  pieces  belong  to  Mr. 
Mabie's  finest  and  strongest  work.  To  read  them  is  to  feel  one's  heart 
calmed,  uplifted,  and  enlarged."^ —  Henry  van  Dyke. 

"The  feeling  for  beauty  that  expresses  itself  in  simplicity,  a  philosophy 
of  life  wholesome  and  attainable,  the  buoyant  energy  and  steadfast  spirit- 
ual vision  that  illuminate  its  pages,  make  it  a  helpful  companion  for  a 
working  day  or  a  dull  day."  —  New  York  Times. 

New  Illustrated  Edition,  $1.50  net 
(postage  8c.) 


PUBLISHED  BY 

THE    MACMILLAN    COMPANY 

64-66  FIFTH  AVENUE,  NEW  YORK 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 

Los  Angeles 
This  book  is  DUE  on  the  last  date  stamped  below. 


JUL  13   1955 


\9^l  9REC0 


7  191 


WAR  3 1  Rat 


4^ 


410EI 


!010JUL2  7  19)i 
a...cflAUGlOV)81 


7       ^ 
^0      ^ 


% 


Form  L9-42m-8,'49(B5573)444 


THE  LIBRARY 

UNIVERSITY  OF  CALIFORNIA 

LOS  ANGELES 


XP<! 


A..,- 


.o. 


3   1158  00694  6643 


